Competition drives hospital heart service add-ons

Hospitals in the United States spent big bucks--about $4 billion--to add angioplasty services between 2004 and 2008, but evidence proved the services didn't do much to improve timely access to care, according to a study published in Circulation: Cardiovascular Quality and Outcomes.

The study found that in 2008, 1,739 U.S. hospitals were capable of performing percutaneous coronary intervention (PCI), a relative increase of 16.5 percent from 2004.

New PCI programs were more likely to be introduced in areas that "already had a PCI program with more competition for market share, near populations with higher rates of private insurance, in states that had weak or no regulation of new cardiac catheterization laboratories, and in wealthier and larger hospitals."

"The typical center did not improve patient care in the United States," Thomas W. Concannon, the study's lead author, an assistant professor at the Tufts University School of Medicine in Boston and a policy researcher at RAND, told Kaiser Health News. "Hospitals are thinking more about the competitiveness issue than the health of the population."

KHN contacted Boca Raton Regional Hospital and Bethesda Memorial Hospital, both in Palm Beach County, Fla., which added angioplasty services between 2004 and 2008 despite both being a 20-minute drive from existing angioplasty centers and claimed the new services were enhancing convenience for patients. Neither hospital would comment on the study.

The study also found about 80 percent of the U.S. population lives within an hour drive of a hospital with angioplasty services, and that hospitals were more likely to add angioplasty services with less state oversight of new services and more patients with private health insurance.

The study concluded, "Our data show that new PCI programs were systematically duplicative of existing programs and did not help patients gain access to timely PCI. The total cost of recent U.S. investments in new PCI programs is large and of questionable value for patients."

To learn more:
- read the study
- read the article from Kaiser Health News

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