[The waiting time for heart interventions: trends for percutaneous coronary interventions and cardiothoracic
R V Huijskes1, K T Koch, L A van Herwerden
1Afd. Klinische Informatiekunde, Academisch Medisch Centrum/Universiteit van Amsterdam, Amsterdam. r.v.huijskes@planet.nl
Insights
Waiting lists for heart interventions in the Netherlands are growing, with fewer patients treated within established standards. A monthly survey proved reliable for tracking these elective heart intervention waiting lists.
Area of Science:
- Cardiovascular medicine
- Public health policy
- Healthcare management
Context:
- The Netherlands faces increasing demand for cardiac procedures.
- Monitoring waiting times for elective heart interventions is crucial for healthcare planning.
- Existing standards for treatment timeliness are under pressure.
Purpose:
- To analyze trends in heart intervention volumes.
- To assess waiting list lengths for percutaneous coronary interventions and cardiothoracic interventions.
- To evaluate the reliability of a national waiting list survey.
Summary:
- Percutaneous coronary interventions have increased, while cardiothoracic interventions remained stable.
- Waiting lists for percutaneous coronary interventions grew by 16% annually, and for cardiothoracic interventions by 20% annually until mid-2001, then decreased.
- Compliance with treatment standards has fallen to 78% for PCI and 53% for cardiothoracic procedures.
Impact:
- Growing waiting lists indicate a need for capacity expansion or efficiency improvements in cardiac care.
- The study validates a reliable method for monitoring elective heart intervention waiting lists.
- Healthcare providers and policymakers can use this data to address treatment delays and improve patient access.
Objective:
(a) To describe trends in the number of heart interventions performed over time, (b) to determine the length of waiting lists for elective heart interventions in the Netherlands according to the monthly survey of the Supervisory Committee for Heart Interventions in the Netherlands [Begeleidingscommissie Hartinterventies Nederland (BHN)], (c) to compare the length of the waiting lists with existing standards, and (d) to determine the reliability of the waiting list survey.
Design:
Prospective.
Method:
Data were obtained from the monthly waiting list survey of the 13 heart centres in the Netherlands (1 January 1999-30 November 2002) and from the intervention registry (1 January 1999-30 June 2001), which was complete for 10 centres. Both the survey and the maintenance of the registry are carried out by the Supervisory Committee for Heart Interventions in the Netherlands.
Results:
(a) The number of percutaneous coronary interventions performed in the Netherlands has increased. The number of cardiothoracic interventions remained stable. (b) The number of patients waiting for a percutaneous coronary intervention is increasing by 16% per annum. In November 2002 there were 751 patients on the waiting list. The number of patients waiting for a cardiothoracic intervention increased by 20% per annum until August 2001 and since then there has been a decrease of 21% per annum. In November 2002, 1557 patients were on the waiting list. (c) The percentage of patients treated within existing standards has fallen to 78% for percutaneous coronary interventions and to 53% for cardiothoracic interventions. (d) The length of the waiting list and the waiting times obtained in the survey concurred with the data taken from the intervention registry.
Conclusions:
The length of the waiting list for heart interventions has increased and complies increasingly less with existing standards. The monthly waiting-list survey was a reliable method of determining the length of waiting lists for elective heart interventions.
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