When a good network of care involving access to specialists and family physicians is established, it can significantly improve the number of lives saved from heart disease, especially in rural areas, according to a University of Alberta two-year study.
Dr. Paul Armstrong, professor of medicine in the University of Alberta's division of cardiology, and one of the study's authors, says more ways are needed to improve timely and appropriate access to specialists and to improve the structuring of collaborative care.
It was found that patients discharged after their first hospital stay for heart failure had far better outcomes if they received regular cardiovascular follow-up visits with a physician, and those who saw both a family practitioner and a specialist had the lowest mortality rates, even with more complicated conditions. Outpatient care involving both a specialist and a family physician was associated with a 66 per cent drop in the risk of one-year mortality. They found that patients who were elderly and living in rural areas had less access to specialty care.
It is now clear that only a minority of heart failure patients are seen in specialty heart failure clinics where it has been shown that outcomes are improved. These clinics are more often than not located in specialty academic centres, and difficult for rural patients to access, said Dr. Armstrong.