Barriers to Access to Cardiac Surgery : Canadian Situation and Global Context

Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved..

Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Cardiovascular care spans primary, secondary, and tertiary prevention and care, whereby tertiary care is particularly prone to disparities in care. Challenges in access to care especially affect low- and middle-income countries (LMICs), however, multiple barriers also exist and persist across high-income countries. Canada is lauded for its universal health coverage but is faced with health care system challenges and substantial geographic barriers. Canada possesses 203 active cardiac surgeons, or 5.02 per million population, ranging from 3.70 per million in Newfoundland and Labrador to 7.48 in Nova Scotia. As such, Canada possesses fewer cardiac surgeons per million population than the average among high-income countries (7.15 per million), albeit more than the global average (1.64 per million) and far higher than the low-income country average (0.04 per million). In Canada, adult cardiac surgeons are active across 32 cardiac centres, representing 0.79 cardiac centres per million population, which is just above the global average (0.73 per million). In addition to centre and workforce variations, barriers to care exist in the form of waiting times, sociodemographic characteristics, insufficient virtual care infrastructure and electronic health record interoperability, and health care governance fragmentation. Meanwhile, Canada has highly favourable surgical outcomes, well established postacute cardiac care infrastructure, considerable spending on health, robust health administrative data, and effective health technology assessment agencies, which provides a foundation for continued improvements in care. In this narrative review, we describe successes and challenges surrounding access to cardiac surgery in Canada and globally.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - year:2023

Enthalten in:

The Canadian journal of cardiology - (2023) vom: 15. Nov.

Sprache:

Englisch

Beteiligte Personen:

Vervoort, Dominique [VerfasserIn]
Afzal, Abdul Muqtader [VerfasserIn]
Ruiz, Gabriela Zamunaro Lopes [VerfasserIn]
Mutema, Chileshe [VerfasserIn]
Wijeysundera, Harindra C [VerfasserIn]
Ouzounian, Maral [VerfasserIn]
Fremes, Stephen E [VerfasserIn]

Links:

Volltext

Themen:

Journal Article
Review

Anmerkungen:

Date Revised 11.03.2024

published: Print-Electronic

Citation Status Publisher

doi:

10.1016/j.cjca.2023.11.011

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM364688122