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Joint programmes in paediatric cardiac surgery: an update and descriptive analysis.

Nikia T Toomey1,2, James Ulysse3, William M DeCampli2,4

  • 1Department of Surgery, University of Tennessee Health Sciences Center, 910 Madison Ave. 2nd Fl., Memphis, TN 38163, USA.

Cardiology in the Young
|June 22, 2022
PubMed
Summary

Joint programmes in congenital cardiac surgery can improve outcomes but are not seen as optimal by most surgeons. Success factors include avoiding complexity limitations, though most programs utilize a "mother-daughter" model.

Keywords:
CHDCardiac surgeryhealth care systemsjoint programmesregionalisation

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Area of Science:

  • Cardiovascular Surgery
  • Healthcare Management
  • Pediatric Cardiology

Background:

  • Joint programmes offer an alternative to regionalization for congenital cardiac surgery.
  • They aim to overcome resource and accessibility challenges.
  • This study investigates their current status and perceived value.

Purpose of the Study:

  • Characterize existing congenital cardiac surgery joint programmes.
  • Identify factors associated with their success and failure.
  • Assess professional attitudes towards joint programmes.

Main Methods:

  • A multiple-choice survey was distributed to pediatric cardiac surgeons in the USA.
  • The survey included 23 general questions and 42 specific questions for joint programme participants.
  • Data collection aimed to qualitatively and quantitatively describe joint programmes.

Main Results:

  • 14 of 34 identified congenital cardiac surgery programmes participate in joint ventures, with 50% existing for over 10 years.
  • Most (86%) utilize a "mother-daughter" model for case distribution and perception.
  • Defunct programmes often failed due to complexity limitations, which independent institutions removed.
  • 71% of participants believe joint programmes improve outcomes, but only 18% consider them optimal.

Conclusions:

  • Joint programmes in congenital cardiac surgery show promise for improving outcomes and managing resources.
  • The
  • mother-daughter
  • model is prevalent.
  • Limitations on case complexity appear detrimental to programme longevity.
  • While beneficial, joint programmes are not universally viewed as the optimal delivery model for congenital cardiac surgical care.