Trends in utilization of specialty care centers in California for adults with congenital heart disease

Am J Cardiol. 2015 May 1;115(9):1298-304. doi: 10.1016/j.amjcard.2015.02.013. Epub 2015 Feb 12.

Trends in utilization of specialty care centers in California for adults with  congenital heart disease.

Fernandes SM1Chamberlain LJ2Grady S Jr3Saynina O4Opotowsky AR5Sanders L2Wise PH6.

Comment: This study examined the location (specialty versus non-specialty center) of cardiac surgery in ACHD, between 2000 and 2011, in California.  There were a total of 4,611 cardiac surgical ACHD cases during this timeframe.  Specialty centers were identified as those centers that had self-identified as specialty center on the ISACHD/ACHA ACHD clinic directory, regardless of cardiac surgical volumes.  Although there has been an increase in the proportion of ACHD surgery in moderate and complex congenital heart disease being performed in specialty centers (from 46% in 2000 to 71% in 2011), 25% of ACHD surgeries in patients continue to be performed at non-specialty centers.  Increasing age, ethnicity, proximity to specialty care, and type of insurance were associated with surgery outside of specialty centers.