Literature DB >> 16717084

Managed Care Network for the assessment of cardiac problems in children in a district general hospital: a working model.

K Pushparajah1, D Garvie, A Hickey, S A Qureshi.   

Abstract

AIM: To assess a model for cardiology assessments in children with suspected heart disease by a general paediatrician with special expertise in paediatric cardiology (PsePC) in a district general hospital.
METHODS: A new monthly "screening" clinic was established in May 2004 by the PsePC to reduce the burden of new referrals on outreach tertiary paediatric cardiology services. All patients were to have echocardiograms as part of their referral for cardiac assessment. Over a one year period (May 2004-April 2005), through audit, details of referrers, indications for referral, echocardiography assessments, and subsequent management were recorded. This was compared with the pattern of patients seen in the joint paediatric cardiology outreach clinics over a two year period (May 2003-April 2005).
RESULTS: In the "screening" clinic, there were 75 appointments for 65 patients seen in 12 months. Fifty five of these patients had normal echocardiographic studies. Of the 47 referrals with heart murmurs in asymptomatic children, four had structurally abnormal hearts on echocardiographic assessment. Between May-October 2003 and November 2003-April 2004, the number of new patients with normal echocardiographic studies seen in the paediatric cardiology outreach clinic was 33/106 (31%) and 28/110 (25.4%) respectively. Following the introduction of the "screening" clinic, the number decreased to 21/99 (21%) during May-October 2004, and 10/102 (9.8%) during November 2004-April 2005.
CONCLUSION: This model can work effectively in order to identify pathology requiring input of a paediatric cardiologist more appropriately. Paediatricians with specific training in paediatric cardiology are potentially well equipped to provide this basic screening service.

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Year:  2006        PMID: 16717084      PMCID: PMC2082959          DOI: 10.1136/adc.2005.086058

Source DB:  PubMed          Journal:  Arch Dis Child        ISSN: 0003-9888            Impact factor:   3.791


  11 in total

1.  Accuracy of clinical assessment of heart murmurs by office based (general practice) paediatricians.

Authors:  I Haney; M Ipp; W Feldman; B W McCrindle
Journal:  Arch Dis Child       Date:  1999-11       Impact factor: 3.791

2.  Comparative study of clinical evaluation of heart murmurs by general pediatricians and pediatric cardiologists.

Authors:  K Rajakumar; M Weisse; A Rosas; E Gunel; L Pyles; W A Neal; A Balian; S Einzig
Journal:  Clin Pediatr (Phila)       Date:  1999-09       Impact factor: 1.168

Review 3.  Neonatal/infant echocardiography by the non-cardiologist: a personal practice, past, present, and future.

Authors:  J L Katumba-Lunyenya
Journal:  Arch Dis Child Fetal Neonatal Ed       Date:  2002-01       Impact factor: 5.747

4.  Open-access paediatric echocardiography: changing role and referral patterns to a consultant-led service in a tertiary referral centre.

Authors:  A T Tybulewicz; M L Rigby; A N Redington
Journal:  Heart       Date:  1996-06       Impact factor: 5.994

5.  Echocardiographic diagnosis of heart disease in apparently healthy adolescents.

Authors:  J Steinberger; J H Moller; J M Berry; A R Sinaiko
Journal:  Pediatrics       Date:  2000-04       Impact factor: 7.124

6.  Increasing workload and changing referral patterns in paediatric cardiology outreach clinics: implications for consultant staffing.

Authors:  M H Wagstaff; M L Rigby; A N Redington
Journal:  Heart       Date:  1998-03       Impact factor: 5.994

7.  Development of a cardiac technician led paediatric echocardiographic service--experience from a district general hospital in the United Kingdom.

Authors:  Jane Allen; David F Dickinson; Arun Ramachandran; John D R Thomson
Journal:  Cardiol Young       Date:  2005-06       Impact factor: 1.093

8.  Evaluation of heart murmurs in children: cost-effectiveness and practical implications.

Authors:  Michael S Yi; Thomas R Kimball; Joel Tsevat; Joseph M Mrus; Uma R Kotagal
Journal:  J Pediatr       Date:  2002-10       Impact factor: 4.406

9.  Diagnostic accuracy of paediatric echocardiograms interpreted by individuals other than paediatric cardiologists.

Authors:  C J Ward; J Purdie
Journal:  J Paediatr Child Health       Date:  2001-08       Impact factor: 1.954

10.  Evaluation of echocardiography on the neonatal unit.

Authors:  S Moss; D J Kitchiner; C W Yoxall; N V Subhedar
Journal:  Arch Dis Child Fetal Neonatal Ed       Date:  2003-07       Impact factor: 5.747

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  1 in total

1.  Paediatricians subspecialising in cardiology: clinical governance, maintenance of expertise, and training.

Authors:  J L Gibbs
Journal:  Arch Dis Child       Date:  2006-11       Impact factor: 3.791

  1 in total

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