Regionalization of Pediatric Heart Surgery…Time for a Change

Abstract

There are too many congenital heart surgery programs in the United States with wide variability in practices, delivery of care, and outcomes. In this issue of The Annals of Thoracic Surgery, Welke and colleagues 1 Welke K.F. Pasquali S.K. Lin P. et al. A theoretical model for delivery of congenital heart surgery in the United States. Ann Thorac Surg. 2021; 111: 1628-1635 Scopus (8) Google Scholar have proposed a radical change toward a “regionalized” model that reduces the number of programs from approximately 150 hospitals to approximately 60. This model would result in optimally placed hospitals and programs in each state so that individual programs perform at least 300 cases a year and the travel burden for patients would be minimized. The ultimate objective of this redesign is improved quality and outcomes for each program. Theoretical Model for Delivery of Congenital Heart Surgery in the United StatesThe Annals of Thoracic SurgeryVol. 111Issue 5PreviewOver 150 hospitals perform congenital heart surgery (CHS) in the United States. Many hospitals are close together, with a median patient travel distance of 38.5 miles. We began with a theoretical blank slate and used objective methodology guided by population density and volume thresholds to estimate the optimal number and locations of hospitals to provide CHS in the United States. Full-Text PDF