< Back to previous page

Project

Toward a sustainable and affordable healthcare: Exploring the potential of subsidiarity in the care for adults with congenital heart disease

Congenital heart disease (CHD) occurs in 9.3 per 1,000 newborns. It comprises a wide spectrum of simple, moderate, and complex severity lesions. To date, more than 90% of children born with CHD can reach adulthood. Irrespective of the treatment received in childhood, these patients cannot be considered to be cured when reaching adulthood, and therefore need life-long care. Since CHD comprises a wide spectrum of heart lesions, patients may be cared for at three levels of care:

  1. care exclusively in a specialist center
  2. care shared between specialists and local general cardiologists
  3. non-specialist care, either by general cardiologists or general practitioners

To date, the anatomical complexity of the patients’ heart defects is predominantly used to determine the appropriate setting of care. Unfortunately, there are currently no empirical data available to support this assignment of patients to the different levels of care. The overall aim of this research project is to develop and test a strategy for risk stratification to determine the most appropriate setting of care for patients with CHD, based on clinical outcomes and healthcare expenditures. The ultimate goal is to develop an empirically-based algorithm that guides clinicians, administrators and policymakers to allocate patients to the most optimal level of care in terms of the best clinical outcomes at the lowest cost.

Date:3 Jul 2017 →  30 Sep 2020
Keywords:Heart defects, congenital, health care utilization, outcomes, mortality, morbidity, chronic diseases, health care expenditures
Disciplines:Cardiac and vascular medicine