Benchmarking the provision of coronary artery bypass grafting surgery in Newfoundland and Labrador

• Main Author: Power, Lorena
• Format: Thesis
• Language: English
• Published: Memorial University of Newfoundland 2003
• Subjects: Newfoundland
• Online Access: https://research.library.mun.ca/11281/; https://research.library.mun.ca/11281/1/Power_Lorena.pdf

Governmental concern for the effective utilization of limited health care resources has necessitated the development of standardized, objective tools to measure and document changes within the health care system. The use of coronary artery bypass grafting surgery (CABGS), like all other health procedures, has high public cost and must be perfom1ed appropriately, when necessary, efficiently, and with high quality of care. Establishing the required frequency of a procedure, CABGS, in a population (benchmarking) is vital to ensure adequate allocation of resources. In 1995 researchers found that CABG surgery in Newfoundland and Labrador (NL) was being appropriately applied but that access to the service was far less than ideal. The authors benchmarked the need for CABGS. The current investigation was designed to reassess the need for CABGS in this province and to provide revised benchmarks. The analysis compared data between study periods and addressed the following areas: the current need for CABGS in NL, the appropriateness of utilization, the necessity of utilization, the waiting times, the quality of care delivered with this service, and the future need of CABGS in NL. -- All patients identified with critical coronary artery disease (CAD) through coronary angiography (CA) between August 18, 1998 and August 13, 1999 were included in the study. In addition, all patients who received CABGS during the same study period were followed for quality of care. Findings were then compared with a previous study (1994/95). -- In 1998/99, 1625 patients had critical coronary artery disease and were characterized by late stage angina symptoms and multi-vessel disease. The average age was 62 years and 75% were male. Four hundred thirty-four patients (434) underwent CABGS during the study period while 517 patients were referred for surgery. Thus, the waitlist increased by ~ 30% throughout the year. Only 40% of patients received surgery within the recommended waiting time. Over 94% of the referrals were deemed necessary. There was ...