51 results on '"Cardiology economics"'
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2. Challenges and Potential Improvements to Patient Access to Pharmaceuticals: Examples From Cardiology.
- Author
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Psotka MA, Fiuzat M, Solomon SD, Chauhan C, Felker GM, Butler J, Teerlink JR, Sinha SS, O'Connor CM, and Konstam MA
- Subjects
- Cardiology economics, Cost-Benefit Analysis, Humans, United States, Cardiovascular Diseases drug therapy, Cardiovascular Diseases economics, Drug Costs, Insurance, Pharmaceutical Services, Pharmaceutical Preparations economics
- Abstract
Patient access to a drug after US regulatory approval is controlled by complex interactions between governmental and third-party payers, pharmacy benefit managers, distributers, manufacturers, health systems, and pharmacies that together mediate the receipt of goods by patients after prescription by clinicians. Recent medication approvals highlight why and how the distribution of clinically beneficial novel therapies is controlled. Although imposed limitations on availability may be rational considering the fiduciary responsibilities of payers and escalating spending on health care and pharmaceuticals, transparency and communication are lacking, and some utilization management may disproportionately affect vulnerable populations. Analysis of the current health insurance landscape suggests mechanisms by which patient access to appropriate medications can be improved and patient and clinician frustration reduced while acknowledging the financial realities of the pharmaceutical marketplace. We propose creation of a shared, standardized, and transparent process for coverage decisions that minimizes administrative barriers and is defensible on the basis of clinical and cost-effectiveness evidence. These reforms would benefit patients and improve the efficiency of the pharmaceutical system.
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- 2020
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3. Value-Based Payment Reforms in Cardiovascular Care: Progress to Date and Next Steps.
- Author
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Sukul D and Eagle KA
- Subjects
- Accountable Care Organizations economics, Cardiology legislation & jurisprudence, Cardiovascular Diseases diagnosis, Health Care Reform legislation & jurisprudence, Health Policy, Humans, Medicare legislation & jurisprudence, Patient Care Bundles economics, Policy Making, Treatment Outcome, United States, Value-Based Purchasing legislation & jurisprudence, Cardiology economics, Cardiovascular Diseases economics, Cardiovascular Diseases therapy, Health Care Costs legislation & jurisprudence, Health Care Reform economics, Medicare economics, Outcome and Process Assessment, Health Care economics, Value-Based Health Insurance economics, Value-Based Purchasing economics
- Abstract
In an effort to curb excessive health care spending and incentivize high-quality care, many payers have implemented value-based payment reforms designed to pay for the quality rather than the quantity of health care services. Medicare, the largest payer in the United States, has implemented numerous value-based payment policies over the past decade, many of which affect cardiovascular care. In this review, we discuss some of these major nationwide value-based payment reforms as they relate to cardiovascular care and what we may expect in the future from cardiovascular value-based policies., Competing Interests: Conflict of Interest Disclosure: The authors have completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported., (© 2020 Houston Methodist Hospital Houston, Texas.)
- Published
- 2020
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4. Paying for Performance Improvement in Quality and Outcomes of Cardiovascular Care: Challenges and Prospects.
- Author
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Husaini M and Joynt Maddox KE
- Subjects
- Cardiology standards, Cardiovascular Diseases diagnosis, Humans, Outcome and Process Assessment, Health Care standards, Patient Care Bundles economics, Quality Improvement economics, Quality Indicators, Health Care economics, Reimbursement, Incentive standards, Treatment Outcome, Value-Based Health Insurance economics, Value-Based Purchasing economics, Cardiology economics, Cardiovascular Diseases economics, Cardiovascular Diseases therapy, Health Care Costs standards, Outcome and Process Assessment, Health Care economics, Reimbursement, Incentive economics
- Abstract
Over the past two decades, Medicare and other payers have been looking at ways to base payment for cardiovascular care on the quality and outcomes of care delivered. Public reporting of hospital performance on a series of quality measures began in 2004 with basic processes of care such as aspirin use and influenza vaccination, and it expanded in later years to include outcomes such as mortality and readmission rates. Following the passage of the Affordable Care Act in March 2010, Medicare and other payers moved forward with pay-for-performance programs, more commonly referred to as value-based purchasing (VBP) programs. These programs are largely based on an underlying fee-for-service payment infrastructure and give hospitals and clinicians bonuses or penalties based on their performance. Another new payment mechanism, called alternative payment models (APMs), aims to move towards episode-based or global payments to improve quality and efficiency. The two most relevant APMs for cardiovascular care include Accountable Care Organizations and bundled payments. Both VBP programs and APMs have challenges related to program efficacy, accuracy, and equity. In fact, despite over a decade of progress in measuring and incentivizing high-quality care delivery within cardiology, major limitations remain. Many of the programs have had little benefit in terms of clinical outcomes yet have led to marked administrative burden for participants. However, there are several encouraging prospects to aid the successful implementation of value-based high-quality cardiovascular care, such as more sophisticated data science to improve risk adjustment and flexible electronic health records to decrease administrative burden. Furthermore, payment models designed specifically for cardiovascular care could incentivize innovative care delivery models that could improve quality and outcomes for patients. This review provides an overview of current efforts, largely at the federal level, to pay for high-quality cardiovascular care and discusses the challenges and prospects related to doing so., Competing Interests: Conflict of Interest Disclosure: Dr. Joynt Maddox does contract work for the United States Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation. There are no other financial conflicts of interest to report., (© 2020 Houston Methodist Hospital Houston, Texas.)
- Published
- 2020
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5. CardioScape-II: the need to map cardiovascular funding patterns in Europe.
- Author
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Pries AR, Vardas P, Ballensiefen W, Cosentino F, Dunkel M, Guzik T, Pearson J, Preissner R, Van de Werf F, and Wood D
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- Biomedical Research economics, Cardiology economics, Databases, Factual, Europe, Humans, Research Support as Topic economics, Time Factors, Biomedical Research trends, Cardiology trends, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases physiopathology, Cardiovascular Diseases therapy, Research Support as Topic trends
- Published
- 2020
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6. President's page: A global opportunity to improve cardiovascular outcomes.
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Blankstein R, Nicol E, Bittencourt M, and Rubinshtein R
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- Cardiovascular Diseases economics, Cardiovascular Diseases mortality, Cardiovascular Diseases therapy, Clinical Competence, Education, Medical, Health Care Costs, Health Services Accessibility, Humans, Insurance, Health, Reimbursement, Predictive Value of Tests, Tomography Scanners, X-Ray Computed, Treatment Outcome, Cardiology economics, Cardiology education, Cardiovascular Diseases diagnostic imaging, Computed Tomography Angiography economics, Computed Tomography Angiography instrumentation, Outcome and Process Assessment, Health Care, Quality Improvement economics, Quality Indicators, Health Care economics, Tomography, X-Ray Computed economics, Tomography, X-Ray Computed instrumentation
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- 2020
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7. Update on cardiovascular prevention in clinical practice: A position paper of the European Association of Preventive Cardiology of the European Society of Cardiology.
- Author
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Piepoli MF, Abreu A, Albus C, Ambrosetti M, Brotons C, Catapano AL, Corra U, Cosyns B, Deaton C, Graham I, Hoes A, Lochen ML, Matrone B, Redon J, Sattar N, Smulders Y, and Tiberi M
- Subjects
- Cardiology economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Cardiovascular Diseases epidemiology, Consensus, Cost-Benefit Analysis, Health Care Costs, Heart Disease Risk Factors, Humans, Preventive Health Services economics, Prognosis, Protective Factors, Risk Assessment, Cardiology standards, Cardiovascular Diseases prevention & control, Preventive Health Services standards
- Abstract
European guidelines on cardiovascular prevention in clinical practice were first published in 1994 and have been regularly updated, most recently in 2016, by the Sixth European Joint Task Force. Given the amount of new information that has become available since then, components from the task force and experts from the European Association of Preventive Cardiology of the European Society of Cardiology were invited to provide a summary and critical review of the most important new studies and evidence since the latest guidelines were published. The structure of the document follows that of the previous document and has six parts: Introduction (epidemiology and cost effectiveness); Cardiovascular risk; How to intervene at the population level; How to intervene at the individual level; Disease-specific interventions; and Settings: where to intervene? In fact, in keeping with the guidelines, greater emphasis has been put on a population-based approach and on disease-specific interventions, avoiding re-interpretation of information already and previously considered. Finally, the presence of several gaps in the knowledge is highlighted.
- Published
- 2020
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8. The Role of the Clinical Pharmacist in a Preventive Cardiology Practice.
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Warden BA, Shapiro MD, and Fazio S
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- Cardiology economics, Cardiology methods, Cost Savings, Drug-Related Side Effects and Adverse Reactions prevention & control, Female, Humans, Male, Medication Adherence statistics & numerical data, Middle Aged, Oregon, Patient Education as Topic economics, Patient Education as Topic methods, Prospective Studies, Cardiology organization & administration, Cardiovascular Diseases prevention & control, Pharmacists economics, Pharmacists organization & administration, Practice Patterns, Physicians', Professional Role
- Abstract
Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. In response, a multidisciplinary team approach, which includes clinical pharmacists, is recommended to improve patient outcomes. The purpose of the study was to describe interventions associated with integration of a clinical pharmacist, with an emphasis on pharmacist-generated patient cost avoidance. Methods: This is a prospective observational study detailing pharmacist-initiated interventions within an academic preventive cardiology service. Interventions targeting pharmacotherapy optimization, side effect management, patient education, medication adherence, and cost avoidance were implemented during shared office visits with providers and/or on provider consultation for remote follow-up. Tabulation of cost avoidance was arranged into 2 formats: clinical interventions implemented by the pharmacist and direct patient out-of-pocket expense reduction. Money saved per clinical intervention was extrapolated from data previously published. Patient out-of-pocket expense prior to and after pharmacist involvement was calculated to assess aggregate yearly patient cost savings. Results: Over 12 months the pharmacist intervened on 974 patients, totaling 3725 interventions. Cost avoidance strategies resulted in yearly savings of $830 748 in aggregate-$149 566 from clinical interventions and $681 182 from patient out-of-pocket expense reduction. Monthly patient out-of-pocket expense was reduced from a median (interquartile range) of $217 ($83.5-$347) before to $5 ($0-$18) after pharmacist intervention. Conclusions : Addition of a clinical pharmacist within an academic preventive cardiology clinic generated substantial pharmacotherapy interventions, resulting in significant cost avoidance for patients. The resulting cost avoidance may result in improved medication adherence and clinical outcomes.
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- 2019
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9. Implementing the National Heart, Lung, and Blood Institute's Strategic Vision in the Division of Cardiovascular Sciences.
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Goff DC Jr, Buxton DB, Pearson GD, Wei GS, Gosselin TE, Addou EA, Stoney CM, Desvigne-Nickens P, Srinivas PR, Galis ZS, Pratt C, Kit KBK, Maric-Bilkan C, Nicastro HL, Wong RP, Sachdev V, Chen J, and Fine L
- Subjects
- Cardiology economics, Cardiology trends, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Humans, United States, Cardiology standards, Cardiovascular Diseases therapy, National Heart, Lung, and Blood Institute (U.S.), Practice Guidelines as Topic
- Abstract
As we commemorate the 70
th Anniversary of the National Heart, Lung, and Blood Institute (NHLBI) and celebrate important milestones that have been achieved by the Division of Cardiovascular Sciences (DCVS), it is imperative that DCVS and the Extramural Research community at-large continue to address critical public health challenges that persist within the area of Cardiovascular Diseases (CVD). The NHLBI's Strategic Vision, developed with extensive input from the extramural research community and published in 2016, included overarching goals and strategic objectives that serve to provide a general blueprint for sustaining the legacy of the Institute by leveraging opportunities in emerging scientific areas (e.g., regenerative medicine, omics technology, data science, precision medicine, and mobile health), finding new ways to address enduring challenges (e.g., social determinants of health, health inequities, prevention, and health promotion), and training the next generation of heart, lung, blood, and sleep researchers. DCVS has developed a strategic vision implementation plan to provide a cardiovascular framing for the pursuit of the Institute's overarching goals and strategic objectives garnered from the input of the broader NHLBI community. This plan highlights six scientific focus areas that demonstrate a cross-cutting and multifaceted approach to addressing cardiovascular sciences, including 1) addressing social determinants of cardiovascular health (CVH) and health inequities, 2) enhancing resilience, 3) promoting CVH and preventing CVD Across the lifespan, 4) eliminating hypertension-related CVD, 5) reducing the burden of heart failure, and 6) preventing vascular dementia. These priorities will guide our efforts in Institute-driven activities in the coming years but will not exclude development of other novel ideas or the support of investigator-initiated grant awards. The DCVS Strategic Vision implementation plan is a living document that will evolve with iterative dialogue with the NHLBI community and adapt as the dynamic scientific landscape changes to seize emerging opportunities., Competing Interests: Disclosures: None of the authors have relationships with industry or conflicts of interest to disclose. The views expressed in this article are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; National Institutes of Health; or the United States Department of Health and Human Services.- Published
- 2019
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10. £30 million award to transform cardiovascular research.
- Author
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Samani NJ
- Subjects
- Cardiovascular Diseases diagnosis, Cardiovascular Diseases physiopathology, Cardiovascular Diseases therapy, Competitive Behavior, Humans, Interdisciplinary Communication, Awards and Prizes, Biomedical Research economics, Cardiology economics, Cardiovascular Diseases economics, Charities economics, Research Support as Topic economics
- Published
- 2019
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11. Current Status of Cardiovascular Medicine in the Aging Society of Japan.
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Yasuda S, Miyamoto Y, and Ogawa H
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- Age Factors, Aged, Aged, 80 and over, Aging, Cardiology economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Delivery of Health Care economics, Female, Health Services Needs and Demand economics, Humans, Japan epidemiology, Male, Middle Aged, Needs Assessment economics, Prognosis, Time Factors, Cardiology trends, Cardiovascular Diseases epidemiology, Cardiovascular Diseases therapy, Delivery of Health Care trends, Health Services Needs and Demand trends, Needs Assessment trends
- Published
- 2018
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12. THE FUTURE OF CARDIOVASCULAR CARE: FROM AFFORDABLE CARE TO THE ACADEMIC MEDICAL CENTER.
- Author
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Konstam MA
- Subjects
- Academic Medical Centers economics, Academic Medical Centers legislation & jurisprudence, Cardiology economics, Cardiology legislation & jurisprudence, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Cardiovascular Diseases epidemiology, Delivery of Health Care, Integrated economics, Delivery of Health Care, Integrated legislation & jurisprudence, Forecasting, Government Regulation, Health Care Costs trends, Humans, Patient Protection and Affordable Care Act economics, Patient Protection and Affordable Care Act legislation & jurisprudence, Policy Making, United States epidemiology, Academic Medical Centers trends, Cardiology trends, Cardiovascular Diseases therapy, Delivery of Health Care, Integrated trends, Patient Protection and Affordable Care Act trends
- Abstract
We are presently seeing exponential advances in medical knowledge and development of therapeutic and diagnostic tools. We have also begun to experience an historic restructuring of our health care system. But health care costs continue to rise, disparities persist, and the chaotic, disjointed, and often thoughtless discourse in Washington threatens to roll back the prior advances. Improvement in patient care will be severely stymied if the threats to academic medical centers are not countered. This paper will explore our present state through the lens of cardiovascular care. It will 1) examine clinical trends; 2) dissect the value and challenges to the Patient Protection and Affordable Care Act; 3) highlight limitations and alternatives to relying on the federal government; and 4) present the Academic Medical System construct, as a structure designed to retain and advance the academic mission., Competing Interests: Potential Conflicts of Interest: None disclosed.
- Published
- 2018
13. Cost-Effectiveness Analysis of Cardiovascular Disease Treatment in Japan.
- Author
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Kodera S, Kiyosue A, Ando J, Akazawa H, Morita H, Watanabe M, and Komuro I
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- Cardiovascular Diseases economics, Humans, Cardiology economics, Cardiovascular Diseases therapy, Cost-Benefit Analysis
- Abstract
The quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER) are important concepts in cost-effectiveness analysis, which is becoming increasingly important in Japan. QALY is used to estimate quality of life (QOL) and life years, and can be used to compare the efficacies of cancer and cardiovascular treatments. ICER is defined as the difference in cost between treatments divided by the difference in their effects, with a smaller ICER indicating better cost-effectiveness. Here, we present a review of cost-effectiveness analyses in Japan as well other countries. A number of treatments were shown to be cost-effective, e.g., statin for secondary prevention of cardiovascular disease, aspirin for primary prevention of cardiovascular disease, DOAC for high-risk atrial fibrillation, beta blockers, ACE inhibitors, and ARB for heart failure, sildenafil and bosentan for pulmonary hypertension, CABG for multi-vessel coronary disease, ICD for ventricular tachycardia, and CRT for heart failure with low ejection fraction, while others were not cost-effective, e.g., epoprostenol for pulmonary hypertension and LVAD for end-stage heart failure. Further investigations are required regarding some treatments, e.g., PCSK-9 inhibitors for familial hypercholesterolemia, PCI for multi-vessel coronary disease, catheter ablation for atrial fibrillation, and TAVI for severe aortic stenosis. Ethical aspects should be taken into consideration when utilizing the results of cost-effectiveness analysis in medical policy.
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- 2017
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14. Pediatric Chest Pain-Low-Probability Referral: A Multi-Institutional Analysis From Standardized Clinical Assessment and Management Plans (SCAMPs®), the Pediatric Health Information Systems Database, and the National Ambulatory Medical Care Survey.
- Author
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Harahsheh AS, O'Byrne ML, Pastor B, Graham DA, and Fulton DR
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- Adolescent, Ambulatory Care economics, Ambulatory Care methods, Cardiology economics, Cardiovascular Diseases complications, Chest Pain etiology, Child, Databases, Factual, Diagnosis, Differential, Echocardiography, Electrocardiography, Exercise Test, Female, Guideline Adherence, Humans, Male, Pediatrics economics, Practice Guidelines as Topic, Probability, Retrospective Studies, Sensitivity and Specificity, United States, Cardiology methods, Cardiovascular Diseases diagnosis, Chest Pain diagnosis, Pediatrics methods, Quality Improvement, Referral and Consultation
- Abstract
We conducted a study to assess test characteristics of red-flag criteria for identifying cardiac disease causing chest pain and technical charges of low-probability referrals. Accuracy of red-flag criteria was ascertained through study of chest pain Standardized Clinical Assessment and Management Plans (SCAMPs®) data. Patients were divided into 2 groups: Group1 (concerning clinical elements) and Group2 (without). We compared incidence of cardiac disease causing chest pain between these 2 groups. Technical charges of Group 2 were analyzed using the Pediatric Health Information System database. Potential savings for the US population was estimated using National Ambulatory Medical Care Survey data. Fifty-two percent of subjects formed Group 1. Cardiac disease causing chest pain was identified in 8/1656 (0.48%). No heart disease was identified in patients in Group 2 ( P = .03). Applying red-flags in determining need for referral identified patients with cardiac disease causing chest pain with 100% sensitivity. Median technical charges for Group 2, over a 4-year period, were US2014$775 559. Eliminating cardiac testing of low-probability referrals would save US2014$3 775 182 in technical charges annually. Red-flag criteria were an effective screen for children with chest pain. Eliminating cardiac testing in children without red-flags for referral has significant technical charge savings.
- Published
- 2017
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15. Discontinuation and non-publication of clinical trials in cardiovascular medicine.
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Roddick AJ, Chan FTS, Stefaniak JD, and Zheng SL
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- Cardiology economics, Cardiovascular Diseases economics, Cardiovascular Diseases therapy, Clinical Trials as Topic economics, Databases, Factual economics, Databases, Factual statistics & numerical data, Early Termination of Clinical Trials economics, Humans, Information Dissemination, Cardiology statistics & numerical data, Cardiovascular Diseases epidemiology, Clinical Trials as Topic statistics & numerical data, Early Termination of Clinical Trials statistics & numerical data
- Abstract
Background: Appropriate dissemination of clinical data is crucial for minimising bias. Despite this, high rates of study discontinuation and non-publication have been reported among clinical trials. Cardiovascular medicine receives a substantial proportion of academic funding; however, predictors of non-publication among cardiovascular trials are not well-established., Methods: The National Clinical Trials database was searched for cardiovascular trials completed between January 2010 and January 2014. Associated publications were identified in Medline or Embase. Relevant variables were extracted and subject to chi-squared and logistic regression to identify predictors of discontinuation and non-publication., Results: After reviewing 2035 trials, 431 trials were included, of which 82.1% (n=354; 119,233 participants) were completed. Among completed trials, 70.3% (n=249; 99,095 participants) were published. Industry funding was associated with increased likelihood of non-publication (odds ratio [OR] 2.84; 95% confidence interval [CI] 1.47-5.51; P=0.002), while non-randomised studies were more likely to remain unpublished than randomised counterparts. Industry-funded studies were over three times more likely to be discontinued than those sponsored by academic institutions (OR 3.89; CI 1.54-9.83; P=0.004). Trials studying heart failure and atrial fibrillation were more likely to be discontinued compared to trials studying coronary artery disease (OR 2.83; CI 1.23-6.51; and OR 3.10; CI 1.21-7.96, respectively). Of the total 135,714 participants, 25,565 were recruited into unpublished studies., Conclusions: Discontinuation and non-publication of cardiovascular trials are common, resulting in data from thousands of participants remaining unpublished. Funding source and randomisation are strong predictors of non-publication, while sponsor type, phase and blinding status are key predictors of discontinuation., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2017
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16. British Heart Foundation reflections on research competition 2016.
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Myat A
- Subjects
- Awards and Prizes, Humans, Image Processing, Computer-Assisted, United Kingdom, Biomedical Research economics, Cardiology economics, Cardiovascular Diseases diagnostic imaging, Cardiovascular Diseases pathology, Foundations economics, Research Support as Topic
- Published
- 2016
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17. Publication Speed, Reporting Metrics, and Citation Impact of Cardiovascular Trials Supported by the National Heart, Lung, and Blood Institute.
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Gordon D, Cooper-Arnold K, and Lauer M
- Subjects
- Bibliometrics, Cardiology economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Delphi Technique, Endpoint Determination, Humans, Intention to Treat Analysis, Journal Impact Factor, National Heart, Lung, and Blood Institute (U.S.) economics, Randomized Controlled Trials as Topic economics, Research Support as Topic economics, Time Factors, Treatment Outcome, United States, Cardiology statistics & numerical data, Cardiovascular Diseases therapy, National Heart, Lung, and Blood Institute (U.S.) statistics & numerical data, Periodicals as Topic statistics & numerical data, Publishing statistics & numerical data, Randomized Controlled Trials as Topic statistics & numerical data, Research Design statistics & numerical data, Research Support as Topic statistics & numerical data
- Abstract
Background: We previously demonstrated that cardiovascular (CV) trials funded by the National Heart, Lung, and Blood Institute (NHLBI) were more likely to be published in a timely manner and receive high raw citation counts if they focused on clinical endpoints. We did not examine the metrics of trial reports, and our citation measures were limited by failure to account for topic-related citation behaviors., Methods and Results: Of 244 CV trials completed between 2000 and 2011, we identified 184 whose main results were published by August 20, 2014. One investigator who was blinded to rapidity of publication and citation data read each publication and characterized it according to modified Delphi criteria. There were 46 trials (25%) that had Delphi scores of 8 or 9 (of a possible 9); these trials published faster (median time from trial completion to publication, 12.6 [interquartile range {IQR}, 6.7 to 23.3] vs. 21.8 [IQR, 12.1 to 34.9] months; P<0.01). They also had better normalized citation impact (median citation percentile for topic and date of publication, with 0 best and 100 worst, 1.92 [IQR, 0.64 to 7.83] vs. 8.41 [IQR, 1.80 to 24.75]; P=0.002). By random forest regression, we found that the 3 most important predictors of normalized citation percentile values were total costs, intention-to-treat analyses (as a modified Delphi quality measure), and focus on clinical (not surrogate) endpoints., Conclusions: NHLBI CV trials were more likely to publish results quickly and yield higher topic-normalized citation impact if they reported results according to well-defined metrics, along with focus on clinical endpoints., (© 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.)
- Published
- 2015
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18. The first pediatric appropriate use criteria: a step towards providing quality care in a cost-effective manner.
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Sachdeva R
- Subjects
- Cardiology economics, Cardiovascular Diseases economics, Child, Child, Preschool, Cost-Benefit Analysis, Echocardiography economics, Female, Humans, Infant, Infant, Newborn, Male, Pediatrics economics, Radiology economics, United States, Cardiology standards, Cardiovascular Diseases diagnostic imaging, Echocardiography standards, Pediatrics standards, Radiology standards
- Published
- 2014
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19. [Judgment of the Federal Social Court - revision dismissed!].
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- Cardiology economics, Cardiology education, Cardiovascular Diseases economics, Contract Services economics, Education, Medical, Continuing legislation & jurisprudence, Fee Schedules economics, Germany, Humans, Internal Medicine economics, Internal Medicine education, National Health Programs economics, Quality Assurance, Health Care economics, Quality Assurance, Health Care legislation & jurisprudence, Radiology economics, Radiology education, Radiology legislation & jurisprudence, Reimbursement Mechanisms economics, Cardiology legislation & jurisprudence, Cardiovascular Diseases diagnosis, Contract Services legislation & jurisprudence, Fee Schedules legislation & jurisprudence, Internal Medicine legislation & jurisprudence, Magnetic Resonance Angiography economics, Magnetic Resonance Imaging economics, National Health Programs legislation & jurisprudence, Reimbursement Mechanisms legislation & jurisprudence
- Published
- 2014
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20. Medical professional liability risk among US cardiologists.
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Mangalmurti S, Seabury SA, Chandra A, Lakdawalla D, Oetgen WJ, and Jena AB
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- Female, Humans, Male, Malpractice economics, Physicians economics, Retrospective Studies, United States epidemiology, Workforce, Cardiology economics, Cardiology legislation & jurisprudence, Cardiovascular Diseases epidemiology, Insurance Claim Reporting, Liability, Legal economics, Malpractice legislation & jurisprudence, Physicians legislation & jurisprudence, Registries
- Abstract
Background: Medical professional liability (MPL) remains a significant burden for physicians, in general, and cardiologists, in particular, as recent research has shown that average MPL defense costs are higher in cardiology than other specialties. Knowledge of the clinical characteristics and outcomes of lawsuits against cardiologists may improve quality of care and risk management., Methods: We analyzed closed MPL claims of 40,916 physicians and 781 cardiologists insured by a large nationwide insurer for ≥1 policy year between 1991 and 2005., Results: The annual percentage of cardiologists facing an MPL claim was 8.6%, compared with 7.4% among physicians overall (P < .01). Among 530 claims, 72 (13.6%) resulted in an indemnity payment, with a median size of $164,988. Mean defense costs for claims resulting in payment were $83,593 (standard deviation (s.d.) $72,901). The time required to close MPL claims was longer for claims with indemnity payment than claims without (29.6 versus 18.9 months; P < .001). More than half of all claims involved a patient's death (304; 57.4%), were based on inpatient care (379; 71.5%), or involved a primary cardiovascular condition (416; 78.4%). Acute coronary syndrome was the most frequent condition (234; 44.2%). Medical professional liability claims involving noncardiovascular conditions were common (66; 12.5%) and included falls or mechanical injuries had while under a cardiologist's care and a failure to diagnose cancer., Conclusions: Rates of malpractice lawsuits are higher among cardiologists than physicians overall. A substantial portion of claims are noncardiovascular in nature., (Copyright © 2014 Mosby, Inc. All rights reserved.)
- Published
- 2014
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21. [Choosing wisely: the Top 5 list of the Italian Association of Hospital Cardiologists (ANMCO)].
- Author
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Bobbio M, Abrignani MG, Caldarola P, Casolo G, Fattirolli F, Gabrielli D, Grimaldi M, Mazzotta G, Roncon L, Tozzi Q, and Vallebona A
- Subjects
- Cardiovascular Agents economics, Cardiovascular Agents therapeutic use, Cost Savings, Decision Making, Diagnostic Imaging economics, Diagnostic Imaging statistics & numerical data, Diagnostic Techniques, Cardiovascular economics, Diagnostic Techniques, Cardiovascular statistics & numerical data, Echocardiography statistics & numerical data, Electrocardiography, Ambulatory statistics & numerical data, Evidence-Based Medicine, Exercise Test statistics & numerical data, Family Practice standards, Humans, Internal Medicine standards, Italy, National Health Programs standards, Pediatrics standards, Cardiology economics, Cardiology standards, Cardiovascular Diseases diagnosis, Cardiovascular Diseases therapy, Disease Management, Health Services Misuse prevention & control, Inappropriate Prescribing prevention & control, Societies, Medical standards, Unnecessary Procedures economics
- Abstract
In recent years, a progressive increase in the number of medical diagnostic and interventional procedures has been observed, namely in cardiology. A significant proportion of them appear inappropriate, i.e. potentially redundant, harmful, costly, and useless. Recently, the document Medical Professionalism in the New Millennium: A Physician Charter, the American Board of Internal Medicine (ABIM) Foundation Putting the Charter into Practice program, JAMA's Less Is More and BMJ's Too Much Medicine series, and the American College of Physicians' High-Value, Cost-Conscious Care initiatives, have all begun to provide direction for physicians to address pervasive overuse in health care. In 2010, the Brody's proposal to scientific societies to indicate the five medical procedures at high inappropriateness risk inspired the widely publicized ABIM Foundation's Choosing Wisely campaign. As part of Choosing Wisely, each participating specialty society has created lists of Things Physicians and Patients Should Question that provide specific, evidence-based recommendations physicians and patients should discuss to help make wise decisions about the most appropriate individual care. In Italy, Slow Medicine launched the analogue campaign Fare di più non significa fare meglio. The Italian Association of Hospital Cardiologists (ANMCO) endorsed the initiative by recognizing the need to optimize available resources, reduce costs and avoid unnecessary cardiovascular assessments, thereby enhancing the more efficient care delivery models. An ad hoc ANMCO Working Group prepared a list of five cardiac procedures that seem inappropriate for routine use in our country and, after an internal revision procedure, these are presented here.
- Published
- 2014
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22. 2013 American Society of Nuclear Cardiology / MedAxiom Nuclear Survey.
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- Cardiology economics, Health Care Costs statistics & numerical data, Humans, Nuclear Medicine economics, United States, Utilization Review, Cardiovascular Diseases diagnostic imaging, Cardiovascular Diseases economics, Diagnostic Imaging economics, Diagnostic Imaging statistics & numerical data, Health Care Surveys, Tomography, Emission-Computed economics, Tomography, Emission-Computed statistics & numerical data
- Published
- 2014
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- View/download PDF
23. Do cardiology quality measures actually improve patient outcomes?
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Chatterjee P and Joynt KE
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- Cardiology economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Clinical Competence standards, Cost-Benefit Analysis, Health Care Costs, Humans, Outcome and Process Assessment, Health Care economics, Quality Improvement economics, Quality Indicators, Health Care economics, Reimbursement, Incentive standards, Treatment Outcome, Value-Based Purchasing, Cardiology standards, Cardiovascular Diseases therapy, Outcome and Process Assessment, Health Care standards, Quality Improvement standards, Quality Indicators, Health Care standards
- Published
- 2014
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24. The disconnect between the guidelines, the appropriate use criteria, and reimbursement coverage decisions: the ultimate dilemma.
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Fogel RI, Epstein AE, Mark Estes NA 3rd, Lindsay BD, DiMarco JP, Kremers MS, Kapa S, Brindis RG, and Russo AM
- Subjects
- Cardiovascular Diseases economics, Humans, United States, American Heart Association, Cardiac Resynchronization Therapy economics, Cardiac Resynchronization Therapy standards, Cardiology economics, Cardiovascular Diseases therapy, Guideline Adherence, Reimbursement Mechanisms standards
- Abstract
Recently, the American College of Cardiology Foundation in collaboration with the Heart Rhythm Society published appropriate use criteria (AUC) for implantable cardioverter-defibrillators and cardiac resynchronization therapy. These criteria were developed to critically review clinical situations that may warrant implantation of an implantable cardioverter-defibrillator or cardiac resynchronization therapy device, and were based on a synthesis of practice guidelines and practical experience from a diverse group of clinicians. When the AUC was drafted, the writing committee recognized that some of the scenarios that were deemed "appropriate" or "may be appropriate" were discordant with the clinical requirements of many payers, including the Medicare National Coverage Determination (NCD). To charge Medicare for a procedure that is not covered by the NCD may be construed as fraud. Discordance between the guidelines, the AUC, and the NCD places clinicians in the difficult dilemma of trying to do the "right thing" for their patients, while recognizing that the "right thing" may not be covered by the payer or insurer. This commentary addresses these issues. Options for reconciling this disconnect are discussed, and recommendations to help clinicians provide the best care for their patients are offered., (Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
25. Numbers needed to treat (lives!) and numbers needed to save (money).
- Author
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Ribichini F, Taggart D, and Vassanelli C
- Subjects
- Cardiac Catheterization economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases mortality, Cost Savings, Cost-Benefit Analysis, Heart Valve Diseases economics, Heart Valve Diseases mortality, Heart Valve Diseases therapy, Heart Valve Prosthesis Implantation economics, Humans, Models, Economic, Treatment Outcome, Cardiology economics, Cardiovascular Diseases economics, Cardiovascular Diseases therapy, Health Care Costs, Numbers Needed To Treat, Outcome and Process Assessment, Health Care economics
- Published
- 2013
- Full Text
- View/download PDF
26. Cost-effectiveness: the ménage à trois having a ratio with one denominator and one numerator.
- Author
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Serruys PW
- Subjects
- Humans, Cardiology economics, Cardiovascular Diseases economics, Cardiovascular Diseases therapy, Health Care Costs, Numbers Needed To Treat, Outcome and Process Assessment, Health Care economics
- Published
- 2013
- Full Text
- View/download PDF
27. The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology.
- Author
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Laslett LJ, Alagona P Jr, Clark BA 3rd, Drozda JP Jr, Saldivar F, Wilson SR, Poe C, and Hart M
- Subjects
- Cardiovascular Agents economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Cardiovascular Diseases therapy, Cardiovascular Surgical Procedures instrumentation, Cardiovascular Surgical Procedures trends, Health Policy, Humans, Prevalence, Risk Factors, Societies, Medical, United States, Workforce, Cardiology economics, Cardiovascular Diseases epidemiology
- Abstract
The environment in which the field of cardiology finds itself has been rapidly changing. This supplement, an expansion of a report created for the Board of Trustees, is intended to provide a timely snapshot of the socio-economic, political, and scientific aspects of this environment as it applies to practice both in the United States and internationally. This publication should assist healthcare professionals looking for the most recent statistics on cardiovascular disease and the risk factors that contribute to it, drug and device trends affecting the industry, and how the practice of cardiology is changing in the United States., (Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
28. Barriers to translating EU and US CVD guidelines into practice in China.
- Author
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Zhao D and Hu D
- Subjects
- Asian People psychology, Attitude of Health Personnel ethnology, Awareness, Cardiology economics, China epidemiology, Cultural Characteristics, Europe, Evidence-Based Medicine economics, Guideline Adherence economics, Health Knowledge, Attitudes, Practice ethnology, Humans, Internationality, Patient Education as Topic, Practice Patterns, Physicians' economics, Socioeconomic Factors, United States, Cardiology standards, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Cardiovascular Diseases ethnology, Cardiovascular Diseases therapy, Evidence-Based Medicine standards, Guideline Adherence standards, Practice Guidelines as Topic standards, Practice Patterns, Physicians' standards
- Abstract
With the increasing globalization of clinical research and evidence, clinical-practice guidelines (CPGs) developed by the European Union (EU) and the USA are also becoming increasingly international. However, these CPGs can encounter barriers to their practical application. In this Perspectives article, we analyze the main obstacles to the application of EU and US CPGs for cardiovascular diseases from the unique perspective of China, and highlight some potential problems in the globalization of CPGs. Currently, China and other countries with limited independent evidence for CPG development must localize or adapt the CPGs developed by the EU, the USA, or international medical organizations, with systematic consideration of cost-effectiveness and alternative strategies on the basis of the available evidence from the native populations. At the same time, comprehensive capabilities to collect and review clinical evidence to produce population-specific CPGs should be developed.
- Published
- 2012
- Full Text
- View/download PDF
29. National spending on cardiovascular disease, 1996-2008.
- Author
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Miller G, Hughes-Cromwick P, and Roehrig C
- Subjects
- Biomedical Research economics, Cardiology trends, Cardiovascular Diseases prevention & control, Humans, United States, Cardiology economics, Cardiovascular Diseases economics, Health Expenditures statistics & numerical data
- Published
- 2011
- Full Text
- View/download PDF
30. Practice landscape: California.
- Author
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Itchhaporia D
- Subjects
- Attitude of Health Personnel, California, Cardiology economics, Cardiovascular Diseases diagnosis, Cost Savings, Health Care Costs trends, Health Care Reform trends, Health Care Surveys, Health Knowledge, Attitudes, Practice, Hospital-Physician Relations, Humans, Insurance, Health, Reimbursement trends, Medicare trends, Practice Management, Medical trends, Practice Patterns, Physicians' economics, Societies, Medical, Time Factors, United States, Cardiology trends, Cardiovascular Diseases therapy, Practice Patterns, Physicians' trends
- Published
- 2010
- Full Text
- View/download PDF
31. Evolving models of cardiovascular practices.
- Author
-
Itchhaporia D
- Subjects
- California, Cardiology economics, Cardiology Service, Hospital economics, Cardiovascular Diseases diagnosis, Cardiovascular Diseases economics, Cooperative Behavior, Hospital-Physician Joint Ventures economics, Humans, Interinstitutional Relations, Cardiology organization & administration, Cardiology Service, Hospital organization & administration, Cardiovascular Diseases therapy, Hospital-Physician Joint Ventures organization & administration, Models, Organizational
- Published
- 2010
- Full Text
- View/download PDF
32. Cardiac MRI: will coverage ever flow?
- Author
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Duszak R Jr
- Subjects
- Humans, United States, Cardiology economics, Cardiovascular Diseases diagnosis, Current Procedural Terminology, Insurance Coverage economics, Magnetic Resonance Imaging economics, Medicare economics, Radiology economics
- Published
- 2009
- Full Text
- View/download PDF
33. Cardiovascular medicine in difficult times of economic recession.
- Author
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Vardas PE
- Subjects
- Greece, Humans, Socioeconomic Factors, Cardiology economics, Cardiovascular Diseases economics, Cost of Illness
- Published
- 2009
34. No ordinary time.
- Author
-
Groom RC
- Subjects
- Cardiology economics, China, Global Health, Humans, United States, Cardiology trends, Cardiovascular Diseases, Earthquakes
- Published
- 2008
35. Utilization management of cardiovascular imaging pre-certification and appropriateness.
- Author
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Hendel RC
- Subjects
- Cardiology economics, Cardiology standards, Cardiovascular Diseases economics, Clinical Competence, Cost-Benefit Analysis, Diagnostic Imaging economics, Diagnostic Imaging standards, Guideline Adherence, Health Care Costs, Humans, Insurance, Health, Reimbursement, Magnetic Resonance Imaging statistics & numerical data, Positron-Emission Tomography statistics & numerical data, Practice Guidelines as Topic, Tomography, Emission-Computed, Single-Photon statistics & numerical data, Tomography, X-Ray Computed statistics & numerical data, Cardiology methods, Cardiovascular Diseases diagnosis, Diagnostic Imaging statistics & numerical data, Eligibility Determination, Quality of Health Care, Unnecessary Procedures
- Abstract
Rapid technological advances with enhanced clinical application have promoted the utility as well the growth of cardiac imaging. However, this has also raised concerns about over-utilization and inappropriate use in imaging. The imaging community, which initially took pride in increasing imaging volume, now fears limited access and reduced reimbursement. Nonclinicians, i.e., payers, have become gatekeepers to cardiac imaging, with decisions often lacking firm foundation within medical literature. The near-ubiquitous presence of radiology benefits managers is clearly impacting on the use of cardiac imaging, often through an indiscriminant reduction in imaging volume. Medical societies and clinicians were slow to respond to spiraling costs of cardiac imaging, but now recognize the need to promote appropriate and cost-conscious use of imaging. Through the development of guidelines and appropriateness criteria, physician-directed efforts are focused on eliminating unnecessary testing and promoting increased awareness of health care costs. This paper attempts to review some of the current issues concerning the responsible use of cardiovascular imaging.
- Published
- 2008
- Full Text
- View/download PDF
36. A view from Tunisia: Habib Haouala, MD, FESC. Interview by Jennifer Taylor.
- Author
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Haouala H
- Subjects
- Diet, Female, Humans, Male, Risk Factors, Social Security, Tunisia, Cardiology economics, Cardiology education, Cardiology methods, Cardiovascular Diseases economics, Cardiovascular Diseases epidemiology, Cardiovascular Diseases therapy
- Published
- 2008
- Full Text
- View/download PDF
37. Business aspects of cardiovascular computed tomography: tackling the challenges.
- Author
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Bateman TM
- Subjects
- Accreditation, Clinical Competence, Cost-Benefit Analysis, Equipment Design, Health Care Costs, Humans, Insurance, Health, Reimbursement, Organizational Objectives, Practice Guidelines as Topic, Predictive Value of Tests, Program Development, Referral and Consultation, Cardiology economics, Cardiology organization & administration, Cardiovascular Diseases diagnostic imaging, Laboratories economics, Laboratories organization & administration, Laboratories statistics & numerical data, Tomography, X-Ray Computed economics, Tomography, X-Ray Computed instrumentation, Tomography, X-Ray Computed statistics & numerical data
- Abstract
The purpose of this article is to provide a comprehensive understanding of the business issues surrounding provision of dedicated cardiovascular computed tomographic imaging. Some of the challenges include high up-front costs, current low utilization relative to scanner capability, and inadequate payments. Cardiovascular computed tomographic imaging is a valuable clinical modality that should be offered by cardiovascular centers-of-excellence. With careful consideration of the business aspects, moderate-to-large size cardiology programs should be able to implement an economically viable cardiovascular computed tomographic service.
- Published
- 2008
- Full Text
- View/download PDF
38. Trends and contexts in European cardiology practice for the next 15 years: the Madrid Declaration: a report from the European Conference on the Future of Cardiology, Madrid, 2-3 June 2006.
- Author
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Escaned J, Rydén L, Zamorano JL, Poole-Wilson P, Fuster V, Gitt A, Fernández-Avilés F, Scholte Op Reimer W, de Teresa E, Alonso-Pulpón L, and Tendera M
- Subjects
- Biomedical Research trends, Cardiology economics, Cardiovascular Diseases economics, Costs and Cost Analysis, Europe, Forecasting, Health Expenditures trends, Humans, Practice Guidelines as Topic, Workforce, Cardiology trends, Cardiovascular Diseases prevention & control
- Abstract
In the near future, the practice of cardiology in Europe will be strongly influenced by a complex interplay of epidemiological, social, economical, professional, and technological evolving factors. The present report summarizes the conclusions of an expert conference organized by the European Society of Cardiology to discuss the interactions between these phenomena, in an attempt to foresee the potential scenario in which cardiovascular healthcare and research will develop in the near future, and to anticipate solutions to the identified problems.
- Published
- 2007
- Full Text
- View/download PDF
39. The players and the stage are changing: the current cardiovascular surgical crisis--is there a future?
- Author
-
Diethrich EB
- Subjects
- Cardiology economics, Cardiology education, Cardiology trends, Cardiovascular Diseases economics, Cardiovascular Surgical Procedures economics, Cardiovascular Surgical Procedures education, Education, Medical, Continuing, Employment economics, Employment trends, Fellowships and Scholarships economics, Fellowships and Scholarships trends, Humans, Internship and Residency economics, Internship and Residency trends, United States, Cardiovascular Diseases surgery, Cardiovascular Surgical Procedures trends
- Published
- 2006
- Full Text
- View/download PDF
40. New technology and the cost of health care.
- Author
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Beller GA
- Subjects
- Humans, United States, Biotechnology economics, Biotechnology trends, Cardiology economics, Cardiology trends, Cardiovascular Diseases economics, Health Care Costs trends
- Published
- 2005
- Full Text
- View/download PDF
41. [Cardiovascular medicine in the updated German diagnosis-related groups (G-DRG) for the year 2004].
- Author
-
Roeder N, Fürstenberg T, Bunzemeier H, and Reinecke H
- Subjects
- Cardiology economics, Cardiology standards, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Cardiovascular Diseases therapy, Diagnosis-Related Groups trends, Diagnostic Techniques, Cardiovascular classification, Diagnostic Techniques, Cardiovascular economics, Diagnostic Techniques, Cardiovascular standards, Germany epidemiology, Humans, National Health Programs economics, National Health Programs standards, Registries, Cardiovascular Diseases classification, Cardiovascular Diseases economics, Diagnosis-Related Groups economics, Diagnosis-Related Groups standards, Quality Assurance, Health Care economics, Quality Assurance, Health Care standards
- Abstract
Based on the medical and economical data of 137 German hospitals including 12 university hospitals, the Institut für das Entgeltsystem im Krankenhaus (InEK) was again authorized by the German Ministry of Health to calculate and develop a refined version of the German diagnosis related groups (G-DRG) for the year 2004. The catalogue of these updated GDRGs was published on October 15' 2003. Furthermore, the grouper programs containing the current algorithms and the cost data on which the new G-DRGs were based have been published in the last few weeks. With regard to cardiovascular DRGs, a number of changes have been introduced in the G-DRG system which have profound consequences for all departments that treat patients with these diseases. In this review, we want to present in detail the key points of this update concerning the DRGs, extra reimbursement for special interventions, and new codes for diagnoses and procedures. Furthermore, the new rules for readmissions of patients in the same hospital are summarized. In conclusion, a number of improvements have been implemented in the updated G-DRG system which had in part been suggested by several national medical societies. These provide the basis for more precise and detailed DRGs but require on the other hand, a precise and complete coding to allow correct grouping procedures. From an economical point of view, it could hardly be summarized whether these improvements would lead to an adequate reimbursement for the treatment costs of patients with cardiovascular diseases since the case-mix of the various departments may vary widely.
- Published
- 2004
- Full Text
- View/download PDF
42. Crunch time for clinical cardiology.
- Author
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Lewis RP
- Subjects
- Cardiac Care Facilities, Cardiology economics, Cardiology education, Cardiovascular Diseases economics, Cardiovascular Diseases epidemiology, Cardiovascular Diseases mortality, Career Choice, Coronary Disease mortality, Forecasting, Health Care Costs, Heart Diseases epidemiology, Heart Diseases mortality, Humans, Hypertension mortality, Prevalence, Quality of Health Care, Stroke mortality, United States, Workforce, Cardiology trends, Cardiovascular Diseases therapy
- Published
- 2003
- Full Text
- View/download PDF
43. What's up doc?
- Author
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Collins-Nakai RL
- Subjects
- Canada, Chronic Disease, Delivery of Health Care economics, Delivery of Health Care standards, Financing, Government economics, Financing, Government trends, Humans, Research economics, Research standards, Societies, Medical economics, Societies, Medical standards, Cardiology economics, Cardiology standards, Cardiology trends, Cardiovascular Diseases therapy, Delivery of Health Care trends, Research trends, Societies, Medical trends
- Published
- 2001
44. New risk factors in primary prevention.
- Author
-
Fox R
- Subjects
- Cardiology economics, Financial Support, Humans, Risk Factors, Cardiovascular Diseases prevention & control, Primary Prevention economics
- Published
- 1999
- Full Text
- View/download PDF
45. Marketing cardiovascular programs: positioning for success.
- Author
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Spallina JM
- Subjects
- Budgets, Cardiology economics, Cardiology Service, Hospital economics, Cooperative Behavior, Health Services Needs and Demand, Humans, Marketing of Health Services economics, Marketing of Health Services standards, Models, Organizational, Planning Techniques, Practice Management, Medical, United States, Cardiology organization & administration, Cardiology Service, Hospital organization & administration, Cardiovascular Diseases therapy, Marketing of Health Services organization & administration
- Published
- 1998
46. [22nd Fall Session of The German Society for Cardiology and Cardiovascular Research. Leipzig, 22-24 October 1998. Abstracts].
- Subjects
- Animals, Humans, Cardiology economics, Cardiology trends, Cardiovascular Diseases diagnosis, Cardiovascular Diseases therapy
- Published
- 1998
47. Managed care in cardiology.
- Author
-
Palank EA
- Subjects
- Cardiology trends, Cardiovascular Diseases therapy, Contract Services statistics & numerical data, Economic Competition, Humans, Insurance, Health, Reimbursement, Managed Care Programs economics, Professional Autonomy, United States, Cardiology economics, Cardiovascular Diseases economics, Managed Care Programs organization & administration
- Abstract
Today, some 60 million individuals suffer from some form of cardiovascular disease, at a cost of +151 billion. Thirty-one billion dollars is spent on coronary artery bypass, angioplasty, and cardiac catheterization alone. Cardiology is being scrutinized by the government, payers and purchasers of healthcare.
- Published
- 1997
48. Preventive cardiology: whose job is it? Who will pay for it? What is the best strategy?
- Author
-
Levy D and Sprecher DL
- Subjects
- Cardiovascular Diseases economics, Health Care Reform economics, Health Care Reform trends, United States, Cardiology economics, Cardiology trends, Cardiovascular Diseases prevention & control
- Published
- 1996
- Full Text
- View/download PDF
49. Task Force 1: The underserved.
- Author
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Haywood LJ, Francis CK, Cregler LL, Freed MD, and Skorton DJ
- Subjects
- Academic Medical Centers, Child, Health Services Accessibility statistics & numerical data, Humans, Medical Laboratory Science, Medically Underserved Area, Rural Health, United States, Urban Health, Workforce, Cardiology economics, Cardiology education, Cardiovascular Diseases ethnology, Health Services Needs and Demand statistics & numerical data
- Abstract
The ACC has affirmed its commitment to universal access to health care. Underserved populations exist in urban and rural centers. Common to each is a paucity of personnel trained in cardiovascular care and a lack of access to preventive and highly technologic services. These factors contribute to a poor health outcome (75). Part of the rural problem can be corrected by the transfer of information to local providers by the use of new information systems. Included would be real-time electronic consultation, on-site subspecialty visits and the appropriate use of nonphysician providers (15). The urban problem requires changes in priorities and responsibilities of the academic health centers toward the communities they serve. Curricula changes of cardiovascular specialists, internists, generalists and nonphysician health care personnel must include diversity in training, physician training of ethnically matched providers in addition to technical excellence and research into methods of patient education and motivation for a healthier life-style (51). Reimbursement must appropriately reward those caring for underserved patients and those providing evaluation and management services (43,52).
- Published
- 1994
- Full Text
- View/download PDF
50. Cardiac registries--their place in healthcare.
- Author
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Little EK and King-Davidson K
- Subjects
- Cardiology economics, Cardiovascular Diseases therapy, Humans, Medical Records Systems, Computerized instrumentation, Outcome Assessment, Health Care organization & administration, United States epidemiology, Cardiovascular Diseases epidemiology, Computer Communication Networks, Registries classification
- Abstract
The largest benefit of having a cardiac registry is quality. Everyone from patients, payers, physicians, and the public wants to know your quality...many hospitals are unprepared to answer these questions.
- Published
- 1992
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