Development of Models for Regional Cardiac Surgery Centers

Abstract

BackgroundThis study aimed to develop the models for regional cardiac surgery centers, which take regional characteristics into consideration, as a policy measure that could alleviate the concentration of cardiac surgery in the metropolitan area and enhance the accessibility for patients who reside in the regions.MethodsTo develop the models and set standards for the necessary personnel and facilities for the initial management plan, we held workshops, debates, and conference meetings with various experts.ResultsAfter partitioning the plan into two parts (the operational autonomy and the functional comprehensiveness), three models were developed: the ‘independent regional cardiac surgery center’ model, the ‘satellite cardiac surgery center within hospitals’ model, and the ‘extended cardiac surgery department within hospitals’ model. Proposals on personnel and facility management for each of the models were also presented. A regional cardiac surgery center model that could be applied to each treatment area was proposed, which was developed based on the anticipated demand for cardiac surgery. The independent model or the satellite model was proposed for Chungcheong, Jeolla, North Gyeongsang, and South Gyeongsang area, where more than 500 cardiac surgeries are performed annually. The extended model was proposed as most effective for the Gangwon and Jeju area, where more than 200 cardiac surgeries are performed annually.ConclusionThe operation of regional cardiac surgery centers with high caliber professionals and quality resources such as optimal equipment and facility size, should enhance regional healthcare accessibility and the quality of cardiac surgery in South Korea.

Regionalization of congenital cardiac surgical care: what it will take

“…On an international level, South Korea proposed a tiered model, but have not implemented it yet [27]. Three levels of CHS centers (in order of decreasing autonomy: 'independent', 'satellite', and 'extended departments') were drafted to be used based on the needs of the region of the country.…”

“…One barrier is the lack of standardized nomenclature for the varying models. Although there is a plethora of literature discussing organic regionalization initiatives in different countries, specific classification and terms for each model, are not uniform [16 ▪▪ ,19,22,26,27]. In this section, we review two main regionalization models, the hub-and-spoke, and the tiered model.…”

An Overview of First 100 Cardiac Surgery Cases at a Newly Developed Satellite Center in Sukkur, Pakistan

“…Cardiac surgery is a field in which there is a high concentration of patients in the metropolitan area because the surgery is mainly carried out in medical institutions located in the metropolitan area. Due to this, policies must be developed in order to enhance the quality of healthcare and the geographical accessibility for patients residing in remote regions [5].…”

“…This figure has been markedly brought down now, so have earlier admissions, reduced traveling time, regular follow-up visits, and cost burden to the patient. The idea of establishing regional cardiac surgery centers has been reported in South Korea to meet the patient's requirements [5]. Also, the training requirement of more and more young cardiac surgeons can be effectively completed as the United States reports shortage of cardiothoracic surgeons by 2020 [6].…”