Regionalization or Access to Care? A Joint Pediatric Heart Care Program That Achieves Both: One Program-Two Sites

Area of Science:

• Pediatric Cardiology
• Congenital Heart Surgery
• Healthcare Management

Background:

• Regionalization of pediatric congenital heart disease (CHD) care aims to improve outcomes.
• Concerns exist regarding potential limitations in patient access to specialized CHD care.
• A joint pediatric heart care program (JPHCP) was established to address these issues through a regionalized model.

Purpose of the Study:

• To detail the implementation of a joint pediatric heart care program (JPHCP) utilizing regionalization.
• To evaluate the impact of this program on access to care and patient outcomes.
• To demonstrate the success of a "one program-two sites" model in pediatric CHD care.

Main Methods:

• Kentucky Children's Hospital (KCH) partnered with Cincinnati Children's Hospital Medical Center (CCHMC) in 2017.
• A collaborative satellite model was developed with shared personnel, conferences, and a transfer system.
• Data on 355 operations performed at KCH between March 2017 and June 2022 were analyzed.

Main Results:

• The JPHCP at KCH performed 355 operations across various acuity levels (STAT 1-4).
• Compared to Society of Thoracic Surgeons (STS) national data, the JPHCP showed a shorter postoperative length of stay.
• The program achieved a lower-than-expected mortality rate for its patient case mix, with two operative mortalities.

Conclusions:

• Affiliation with a high-volume center enabled excellent congenital heart surgery results at KCH.
• The JPHCP model successfully improved access to specialized care for children in a more remote location.
• This regionalized, collaborative approach demonstrates a viable strategy for enhancing pediatric CHD care delivery.