Direct emergency medical services transport in STEMI: breaking the bank for non-PCI capable hospitals?
Year: 2015
Type: editorial
Abstract: Direct emergency medical services (EMS) transport of patients with ST-elevation myocardial infarction (STEMI) to a percutaneous coronary intervention (PCI)-capable hospital is emerging as an effective strategy to improve care and reduce costs. This approach has been shown to improve mortality,1 decrease time to reperfusion,2 and reduce overall costs.3 Accordingly, the 2013 updated American Heart Association/American College of Cardiology (AHA/ACC) Guidelines for STEMI management now include a class I recommendation for direct EMS transport to a PCI-capable hospital for patients with STEMI,4 and EMS systems of care are maturing to facilitate this approach. Despite these important trends, however, some communities remain reluctant to implement direct EMS transport for various reasons. The study by Pathak et al 5 published in Open Heart provides critical insight into one of the most frequently-cited concerns raised by skeptics: revenue loss at non-PCI capable hospitals as lucrative cardiovascular services are diverted away.6
Opponents to direct EMS transport have long perceived the practice will financially jeopardise smaller hospitals in rural and underserved communities given the large role cardiovascular services play in subsidising less reimbursed care. Pathak et al respond to this assertion with an interesting analysis of Florida's hospital discharge data from 2006. The Florida Agency for Health Care Administration includes all discharge claims from 100% of Florida hospitals due to statewide mandatory reporting. The authors defined hospitals susceptible to losing patients through direct EMS …
Source: Open Heart
Institutions: University of Michigan, Michigan Medicine
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,391
OpenAlex ID: W2284941617