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CARDIAC CARE SERVICE LINESThere are many types of heart problems and ways to treat them. VHI groups these different conditions and treatments into service lines to better compare care provided.
MEDICAL CARDIOLOGY includes diagnosing and therapy for heart disease. AnginaAngina
literally means "choking pain," and angina pectoris refers to a painful or uncomfortable sensation in the chest that occurs when part of the heart does not receive enough oxygen due to disease in the coronary arteries that supply blood to the heart.
More info at:
www.ehealthmd.com/library/ angina/ANG_whatis.html , congestive heart failureCongestive Heart Failure (CHF)
or heart failure, is a condition in which the heart can not pump enough blood to the body's other organs.
For more information on signs and symptoms, tests, and treatment, visit: www.americanheart.org/ presenter.jhtml?identifier=4585 and acute myocardial infarction (AMI)Acute Myocardial Infarction (AMI)
heart attack occurs when the supply of blood and oxygen to an area of heart muscle is blocked, usually by a clot in a coronary artery. If treatment is not started quickly, the affected area of heart muscle begins to die.
More info at: www.nhlbi.nih.gov/health/dci/ Diseases/HeartAttack/ HeartAttack_WhatIs.html are all examples of heart conditions. When treatment for these conditions does not include surgery, VHI has grouped them into the MEDICAL CARDIOLOGY service line.
INVASIVE CARDIOLOGY includes patients with medical conditions generally described in the medical cardiology service line that also had surgery. Surgeries include cardiac catheterizationCardiac Catheterization
or angiogram is a procedure that identifies possible problems with your heart or its arteries. During a cath, a thin plastic tube, called a catheter, is inserted into a blood vessel in your groin or arm. The catheter is guided up toward your heart. A special dye is injected into the catheter so X-rays can show if you have any artery blockage or other heart problems. www.americanheart.org/ presenter.jhtml?identifier=4491, cardiac pacemaker insertion, balloon angioplastyBalloon Angioplasty
(AN-je-o-plast-tee) involves temporarily inserting and expanding a tiny balloon at the site of your blockage to help widen a narrowed artery. and placement of cardiac stentsCardiac Stent
angioplasty is usually combined with implantation of a small metal coil called a stent in the clogged artery to help prop it open and decrease the chance of it narrowing again (restenosis)..
OPEN HEART SURGERY includes procedures such as coronary artery bypass surgery (CABG)Coronary Artery Bypass Graft (CABG)
also called coronary artery bypass surgery, heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease. Arteries and/or veins from elsewhere in the patient's body are grafted from the aorta to the coronary arteries to bypass atherosclerotic narrowings and improve the blood supply to the coronary circulation supplying the myocardium (heart muscle).
More info: http://en.wikipedia.org/wiki/Coronary_artery _bypass_surgery and cardiac valve proceduresCardiac Valve Procedure
When a valve in the heart is not properly controlling the flow of blood, cardiac surgeons repair or replace the defective valve.
TheAll Patient Refined-Diagnosis Related Groups were developed by 3M Health Information Systems.
DATA COLLECTION AND SCREENS
To ensure that the methodology was as sensitive as possible to variations in patient outcomes by clinical condition, VHI made a decision to focus on a limited number of service lines. Cardiac Care discharges were chosen because they occur frequently. As a group they are the largest category of discharges after normal newborns/obstetrics and represent over 12% of Virginia discharges. Analysis also noted that most hospitals treat patients needing Cardiac Care, and preliminary analysis indicated that the APR-DRG adjustment methodology was explaining a high degree of variation among discharges.
Development of these reports began with Virginia hospital discharges in calendar year 2000. Detailed statistical analysis and review followed to help identify variables outside the control of hospitals that might affect mortality outcomes. In 2006 a cardiac care expert panel provided provided input on the adjustment methodology and recommended adoption of using version 20.0 of 3M's APR-DRGs and a methodology for identifying 30-day related readmissions.
INDICATORS OF CLINICAL ASSESSMENT
For a more technical review of APR-DRG assessment, please click here to view the section VALIDATING APR-DRGs FOR CARDIAC CARE.