Families rally for heart surgery

Delegates hear pleas for open-heart units at additional hospitals

March 06, 2001|By M. William Salganik | M. William Salganik,SUN STAFF

Relatives of patients joined the usual lobbyists, hospital executives and medical experts yesterday in debating whether the state needs more open-heart surgery programs.

Tamiko Campbell of Catonsville said her husband died after being transferred for heart treatment. "If we had open-heart surgery at St. Agnes, I know he'd be here with me today," she said.

She testified at a hearing on a bill that would make it easier for hospitals to start open-heart programs, repeating the sentiments she stated as one of several speakers at a pre-hearing rally in Annapolis attended by about 150 people - most arriving on buses arranged by St. Agnes HealthCare - supporting the legislation.

Although similar bills have failed in the past, "a tack we're doing differently this year is trying to get the citizens involved in this," said Del. Thomas E. Dewberry, a Baltimore County Democrat who is a principal sponsor of legislation that would make it easier to start open-heart programs. He said he hoped other hospitals would join St. Agnes in mobilizing community support, and then "we could really open some eyes."

He said he got interested in the issue five years ago, when his mother died after being transported from St. Agnes, which doesn't do open-heart surgery, to Sinai Hospital, then to Johns Hopkins Hospital, for surgery.

On the other side of the issue, state health planners and representatives of hospitals that have open-heart programs said patients fare better when getting cardiac surgery at hospitals that do a lot of it.

Allowing more hospitals to perform the surgery, they argued, would reduce the volume and dilute quality at existing programs.

"This is life and death," Dr. Henry Meilman, a cardiologist at Union Memorial Hospital, told the House Environmental Matters Committee. "If you have a bunch of low-volume hospitals, the only beneficiaries are going to be the morticians."

Under current rules, state planners do "needs projections" every three years and decide whether new programs are needed in heart surgery and in other highly specialized areas, such as trauma centers and newborn intensive-care units.

Open-heart programs exist at five hospitals in the Baltimore area, three in Washington's Maryland suburbs and one each on the Eastern Shore and in Western Maryland.

Patients who arrive at other hospitals with heart problems often are transported to one of the open-heart hospitals for treatment. There were 6,800 such transfers in Maryland last year, Kenneth Bancroft, president and chief executive officer of St. Agnes, told the committee.

Jay Schwartz, a lobbyist representing St. Agnes, told the committee that a study found Maryland patients who were transported for heart treatment were 39 percent more likely to die than those who went to the hospitals that had heart programs.

Lawrence Merlis, president and chief executive officer of Greater Baltimore Medical Center, said patients would benefit if more hospitals were able to offer life-saving care and that heart attack patients would receive "treatment in the shortest possible time."

Barbara McLean, acting executive director of the Maryland Health Care Commission, said the data Schwartz pointed to were not "risk-adjusted" to account for how sick the patients were upon arrival at the hospital.

Schwartz said after the hearing that the data were risk-adjusted but that the study was in draft form and that he could not yet provide a copy.

McLean pointed out to the committee a number of non-Maryland studies published in medical journals that concluded that hospitals that perform a high volume of heart surgery have better patient outcomes.

If the legislation passes, as many as 14 more Maryland hospitals could begin to offer open-heart surgery, said Pamela Barclay, the commission's deputy director for health resources.

"This would mean a capital cost of $28 million to $42 million to care for the same number of patients," she testified.

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