Health system capacity and infrastructure for adopting innovations to care for patients with venous thromboembolic disease
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A new study published today in Open Medicine takes a look at the availability of infrastructure to permit optimal care for patients with venous thromboembolic disease. The study appears online on Open Medicine.
Venous thromboembolic disease, or VTE, is common in Canada. Many of us know it through its two main manifestations, deep vein thrombosis and pulmonary embolism. As the population ages, and given its tendency to act as a chronic or recurrent condition, VTE is becoming a large and expensive driver of hospital use.
At the same time, thanks to therapeutic and diagnostic innovations, care and diagnosis for VTE have evolved considerably. In this study, the authors examined the capacity of hospitals to actually provide this optimal, evidence-based care for VTE. To this end, they studied health system infrastructure for care of VTE disease in all 10 provinces and 3 territories—94 health regions altogether. They also interviewed health system managers or clinical leaders from all 658 acute care hospitals in the country.
Disturbingly, they found that there is a wide variation—geographically—in the infrastructure needed to diagnose and treat VTE disease, with less-populous provinces and territories more lacking in the infrastructure to provide cutting-edge care.
“We wanted to focus on infrastructure as essential prerequisites for everything else—for example, the right imaging in the right time frame… When structure is not optimal then processes of care are not optimal and that does lead to adverse events for patients,” explains study author William Ghali. These events might for example include bleeding or second clot events, delayed treatment or unnecessary treatment.
The present study may function as a tool for health care administrators with a mandate to improve care to ensure that the necessary infrastructure is in place to better diagnose and treat VTE.
“These are things that can be done with actual potential savings,” Ghali says. “VTE is a big ticket item that's going to be a bigger ticket item, as an aging population will have an increased risk.”
Danielle A. Southern, MSc, is a Programmer/Analyst in the Department of Community Health Sciences and a member of the Institute for Public Health, University of Calgary, Calgary, Alberta. Jasmine Poole is a Research Assistant in the Department of Medicine, McGill University Health Centre, Montreal,Quebec. Alka Patel, PhD, is an Adjunct Assistant Professor in the Department of Community Health Sciences and a member of the Institute for Public Health, University of Calgary, Calgary, Alberta. Nigel Waters, PhD, is a Professor in the Department of Geography and GeoInformation Science, George Mason University, Fairfax, Virginia. Louise Pilote, MD, MPH, PhD, is a Professor in the Department of Medicine, McGill University Health Centre, Montreal, Quebec. Russell D. Hull, MBBS, MSc, is a Professor in the Faculty of Medicine, University of Calgary, Calgary, Alberta. William A. Ghali, MD, MPH, FRCPC,is a Professor in the Departments of Community Health Sciences and of Medicine and is Director of the Institute for Public Health, University of Calgary, Calgary, Alberta.
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