Joint outpatient clinics for the adult with congenital heart disease at the district general hospital: an alternative model of care

Comorbidity, healthcare utilisation and process of care measures in patients with congenital heart disease in the UK: cross-sectional, population-based study with case-control analysis

“…Although this patient population is relatively small when viewed in the context of the major chronic diseases such as coronary heart disease and diabetes, an increase in the numbers of adult patients with congenital heart disease owing to improved survival has been widely predicted 3 12 17 34. Consequently, the healthcare needs and demands of patients with congenital heart disease can only be expected to grow in future.…”

“…Patterns of health service use, beyond admissions to, and surgical procedures performed in, tertiary centres,15 16 are also poorly understood. No studies have been undertaken looking at the burden of morbidity associated with congenital heart disease from a primary care perspective, and there are only a handful of studies describing the activity and case mix of services for adults with congenital heart disease in non-tertiary hospital settings 17 18…”

Cardiopatia congênita no adulto: perfil clínico ambulatorial no Hospital das Clínicas de Ribeirão Preto

“…The study conducted by Gatzoulis et al 18 of the Toronto Hospital shows that 27% of non-operated patients were outpatients, a fact that certainly is related to the large pediatric surgical activity at the institution. In turn, the figures provided by Shirodara et al 19 who reported that 66% of non-operated patients were treated at his clinic, reflected the experience of a smaller district center. Among our cases, in the analysis of the three experiments, we also noticed similarities regarding the main diagnoses, except for a slightly smaller number of patients with systemic obstruction and complex congenital heart disease.…”

“…The comparison of these data with information from other services in the country is difficult, for publications with these characteristics, which would be extremely desirable, are not available in our country. However, experiences from other outpatient centers that have been published 18,19 allowed for this type of analysis. Initially, we noted that our population of operated female patients was slightly larger (56%) compared with the studies mentioned above (47% and 49%, respectively), probably due to the large number of patients who underwent ASD occlusion among our cases.…”

Recommendations for starting a grown up congenital heart disease (GUCH) unit

“…After patient assessment, a decision has to be made regarding where the follow up is going to occur taking into consideration geographical aspects, individual locomotion and social details. Outreach clinics, a strategy adopted in some places for paediatric cardiology patients and not routinely established in our country, can also be employed for adults with CHD [ 30 ] . This model of assistance, allowing a specialized consultation, can also be useful to identify those in need of a close follow up [ 31 ] .…”