Cath Lab Digest - May 2008 - (Page 32)

32 INTERNATIONAL LABS MAY 2008 Cardiac Cath Lab Economics in a Public Hospital of a Developing Country F. Petersen-Aranguren, MD, FACC, L. Jauregui-Plascencia, MD Cardiology Department and Cardiac Catheterization Laboratory Hospital Civil de Guadalajara “Fray Antonio Alcalde” Guadalajara, México Introduction Managing the planning, operation and results of a cardiac catheterization laboratory in a general public university hospital is definitely an enormous task, especially when the hospital budget does not include the cath lab. We are reporting the financial results of our first 1,000 cases in the university public hospital, Hospital Civil de Guadalajara “Fray Antonio Alcalde,” serving a population of approximately 6 million people in the northwestern part of Mexico. Our hospital is the largest hospital in our country, with 1500 beds for the main areas of medical treatment and 67 subspecialty areas. At this time, our sponsors are still Cardiopace (Medtronic, Santa Rosa, CA) and Promedica Garcia (Cordis Corporation, Miami, FL) which work on our inventory supply method: bringing to the hospital the necessary material for the procedures, deploying it and charging the patient for the material used. The cardiology department has 30 beds for adults, more than 8000 outpatient cardiac consults, more than 1,500 admissions and 1,700 echocardiograms per year, along with 2 interventionalists and 9 cardiology fellows. The cath lab team is composed of Luis Jauregui-Plascencia, MD, F. Petersen-Aranguren, MD, FACC, Ignacio Campos-Becerra, technician, and Maria Luisa Segura, RN. At Hospital Civil de Guadalajara “Fray Antonio Alcalde,” we based our program on the use of lease agreements and purchased material as described previously in other institutions1,2 so that we could provide the mechanisms to enhance revenues, utilize new resources, improve patient care, and avoid costly and duplicate capital outlays. Since the hospital budget does not pay for the material, there is no legal imposition as to offer in public license the amount of budget necessary for the investment. Table 1. Prices for Procedures at Hospital Civil de Guadalajara “Fray Antonio Alcalde.” 1. Diagnostic cardiac cath: 2. Cardiac angioplasty: 3. Coronary stents: (1) bare (1) coated 4. Electrophysiology studies: 5. Valvuloplasty: 6. Pacemakers: 1 chamber 2 chamber USD $400 $1,050 $2,100 $3,500 $800 $2,500 $1,850 $2,850 Pesos $4,100 $10,500 $21,000 $35,000 $8,000 $25,000 $18,500 $28,500 The Cath Lab and Getting Started We first realized it was necessary to develop an interventional cardiology program in our facility when the cardiac surgery department opened in 2002. The cath lab opened three years later. Prior to opening, patients traveled to a private hospital for procedures, which brought the risk of transportation and the higher costs of procedures with it. Management of the cardiac cath lab was handled without a single catheter being provided by the hospital. Our ultimate goal was to perform high-quality invasive cardiology procedures with highest levels of safety. The cardiac program had to meet the needs of the following three groups: 1. The industry 2. The physician (cardiologists) 3. The patient The patient had to be provided with the best materials for the procedure at the lowest price. The physician had to have the best possible material that would allow him to be Figure 1. Procedure type for the first 1000 patients Table 2. Income and Revenue for the Cath Lab (in USD) Procedure Diagnostic PTCA and stents Biopsy Valvuloplasty EP studies Pacemakers Total Number 533 261 4 5 20 177 1,000 Cost $218,530 $548,100 $2,000 $2,500 $800 Material $163,897 $411,075 $1,500 $1,875 $600 Revenue $54,632 $137,025 $500 $625 $200 $771,930 $578,947 $192,982 This article received double-blind peer review by members of the Cath Lab Digest Editorial Board.

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Cath Lab Digest - May 2008 The King Faisal Specialist Hospital and Research Centre Cell Therapy in the Cath Lab for Heart Failure: A Look at MyoCell® Therapy and the SEISMIC Trial Performance Improvement Strategies Speed Up Treatment Times in the Management of ST-Elevation Myocardial Infarction (STEMI) Patients Contents Clinical Editor’s Corner Commentary: Performance Improvement Strategies Speed Up Treatment Times in the Management of ST-Elevation Myocardial Infarction (STEMI) Patients Ask the STEMI Expert Comparing Drug-Eluting Stents and Bare-Metal Stents SICP: The Ten-Minute Interview with… Christopher Kambak, RT(R) Cardiac Cath Lab Economics in a Public Hospital of a Developing Country Keeping Your Heart & Vascular Employees: Proven Ideas for an Effective Retention Plan Unspoken Words Ask the Clinical Instructor Society of Invasive Cardiovascular Professionals Meetings Calendar Education Center What Do You Think? Clinical & Industry News Classifieds Advertisers Index

Cath Lab Digest - May 2008

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