St. Agnes to again try for open-heart surgery

Consultant's study spurs hospital's bid to do procedure

January 17, 2002|By M. William Salganik | M. William Salganik,SUN STAFF

St. Agnes HealthCare, armed with a new consultant study, is launching another effort to persuade legislators and regulators to allow it to perform open-heart surgery.

St. Agnes officials were to meet today with regulators who control heart surgery programs in the state, Kenneth H. Bancroft, president and chief executive officer of the Southwest Baltimore hospital, said yesterday.

Bancroft said the hospital also would seek legislative support in the General Assembly.

Hospitals have been battling each other for years over the programs, which bring prestige and revenue. Hospitals that don't have them, such as St. Agnes, say they can provide better care if they can perform the surgery rather than send patients to other hospitals for operations. Hospitals that already have the program - there are five in the Baltimore region - say patients receive better care at lower cost from a few programs that do the surgery often enough to be familiar with it.

Bancroft tried unsuccessfully last year to get legislation permitting more programs. Also, in October 2000, the Maryland Health Care Commission decided that no more open-heart programs were needed in the Baltimore region, although it voted to add one in the Washington suburbs. It is reviewing applications from four hospitals competing to offer the one new program there.

"It's not only a professional issue with me, it's a personal issue," Bancroft said. He said since last year's round of hearings, he has undergone angioplasty - a procedure in which a tiny balloon is used to open clogged blood vessels - twice. Since angioplasty is generally performed at hospitals that also can perform open-heart surgery, Bancroft had to be transferred from St. Agnes to another hospital.

"I've done the whole bit. I've done the ambulance thing," he said. "I'm able to see it through the eyes of a patient."

St. Agnes transfers about 700 patients a year to open-heart hospitals for procedures it cannot perform, he said.

Barbara McLean, executive director of the Maryland Health Care Commission, said she will consider St. Agnes' arguments but, at this point, the commission has no plans to review the issue before next year, when it is due to update its open-heart projections. "We had a process in place," she said. "We went through the process. I don't know what else we can do."

So far, she said, the commission believes that programs at Johns Hopkins, the University of Maryland, Sinai, St. Joseph and Union Memorial are sufficient to meet the need in the Baltimore region. She noted that the number of open-heart surgeries has been increasing very slowly.

Conrad Vernon, the consultant to St. Agnes, said yesterday that his review shows that in Maryland and the District of Columbia there are about 1.8 heart surgeries per 1,000 population, compared with a national average of 2.5.

"There is, in our opinion, a major capacity problem in the state of Maryland," he said. If there were more programs, he said, there would be more surgery and healthier hearts. Vernon is executive vice president of John Goodman and Associates Inc., a cardiovascular consulting firm based in Las Vegas.

In 20 years of consulting for about 500 hospitals, Verson said, he had never seen one with the cardiology resources of St. Agnes that didn't perform heart surgery.

On the other hand, there is no evidence that Maryland patients have to wait for surgery now, said John Marzano, spokesman for MedStar Health, which operates heart programs at Union Memorial Hospital in Baltimore and at Washington Hospital Center and Georgetown University Hospital in Washington.

"We continue to feel that additional programs would dilute care and result in poor outcomes," Marzano said.

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