The current chaotic
healthcare environment blocks improvements in the care of people with
cardiovascular disease, said Robert Brook, MD, ScD,
professor of medicine at the University of California at Los Angeles
and director of the Health Sciences Program for the RAND
Corporation.
"We are clinically practicing in a chaotic environment where some are
getting treatment they don't need and others aren't getting the
treatment they do need," said Brook during the first session of
Cardiovascular Health: Coming Together for the 21st
Century: A National Conference. To buttress his argument, he pointed to
the following findings:
© 1998 American Heart Association, Inc.
Cardiovascular News
Summary of Cardiovascular Health Conference
A national study showed that only 35% of smokers were
advised by their physicians to quit smoking, and a second stated that
only 65% of adults had had their blood cholesterol
measured in the past 5 years. Only 41% of fee-for-service patients and 54% of HMO patients had
their hypertension controlled in a study of 4 group practices in
Massachusetts. In a study of Medicare patients, 17% of coronary
angiographies were deemed inappropriate, as were 14% of
coronary artery bypass surgeries. A study of 5 California hospitals showed that 25% of those who
needed a cardiac revascularization procedure were
not offered one, but at the same time, hospitals were performing such
procedures on people who did not need them. Similarly, another study of California hospitals found unnecessary
coronary angiographies and other surgeries were being
performed. In that study, Brook said, 50% of those individuals who met
the necessary criteria for a coronary angiography did not