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Outpatient clinics for adults with congenital heart disease: increasing workload and evolving patterns of referral

M A Gatzoulis1, S Hechter, S C Siu

  • 1Toronto Congenital Cardiac Centre for Adults, The Toronto Hospital, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.

Heart (British Cardiac Society)
|April 30, 1999
PubMed

Insights

Adult congenital heart disease (ACHD) patients are increasingly seeking specialized care, leading to a significant rise in outpatient service workload. Referral patterns have evolved, with more community-based physicians referring patients for ACHD management.

Area of Science:

  • Cardiology
  • Adult Congenital Heart Disease (ACHD)
  • Healthcare Services Research

Background:

  • Adults with congenital heart disease (ACHD) are living longer and require specialized lifelong care.
  • Outpatient services play a crucial role in managing the complex needs of this growing population.
  • Understanding trends in ACHD care is essential for service planning and resource allocation.

Purpose of the Study:

  • To analyze the changing role and increasing demand for specialized outpatient services for adults with congenital heart disease.
  • To examine shifts in referral patterns to a tertiary ACHD center over a decade.

Main Methods:

  • Retrospective analysis of patient data from a tertiary referral center.
  • Inclusion of data from three distinct three-month periods in 1987, 1992, and 1997.
  • Assessment of patient demographics, referral sources, and diagnostic investigations.

Main Results:

  • A substantial increase in clinic workload was observed, with 44% and 269% growth between 1987-1992 and 1992-1997, respectively.
  • The mean age of patients decreased significantly over time, indicating earlier access to specialized care.
  • Referrals from community cardiologists and family physicians increased substantially, alongside a rise in patients with prior reparative surgery and reoperations.

Conclusions:

  • Specialized adult congenital heart disease (ACHD) outpatient services have experienced significant growth in demand over the past decade.
  • Referral patterns have shifted, with an increasing proportion of patients being referred from non-specialized sources.
  • These findings highlight the need for strategic planning to accommodate the expanding population of ACHD patients requiring specialized tertiary care.
Abstract

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