A percutaneous coronary intervention lab in every hospital?

Abstract

Background: In 2001, 1176 US hospitals were capable of performing primary percutaneous coronary intervention (PCI), and 79% of the population lived within 60-minute ground transport of these hospitals. We compared these estimates with data from 2006 to explore how hospital PCI capability and population access have changed over time.

Methods and results: We estimated the proportion of the population 18 years of age or older, living in 2006 within a 60-minute drive of a PCI-capable hospital, and we compared our estimate with a previously published report on 2001 data. Over the 5-year period, the number of PCI-capable hospitals grew from 1176 to 1695 hospitals, a relative increase of 44%; access to the procedure grew from 79.0% to 79.9% of the population, a relative increase of 1%.

Conclusions: Our data indicate a large increase in the number of hospitals capable of performing PCI from 2001 to 2006, but this increase was not associated with an appreciable change in the proportion of the population with access to the procedure. In the future, more attention is needed on changes in PCI capacity over time and on the effects of these changes on outcomes of interest such as service utilization, expenditures, patient outcomes, and population health.

Figure

This map illustrates 60-minute drive times surrounding percutaneous coronary intervention (PCI) programs at US hospitals and shows state-by-state data sources that were used to estimate PCI capability. Access to PCI is depicted in black for areas in which the closest hospital was PCI-capable, in dark gray for areas lying within a 60-minute drive of a PCI-capable hospital, in light gray for areas served only by a part-time PCI hospital, and in white for areas lying beyond a 60-minute drive to a PCI-capable hospital. States without a hatch-marked background are those in which only American Hospital Association (AHA) data were available. States with a single-hatched background are those in which AHA and Health Care Cost and Utilization Project (HCUP) data (with time stamps) were available. States with a double-hatched background are those in which both AHA and HCUP data (without time stamps) were available.