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DOCUMENT RESU111
04047 - (B325446]
Sharinq Cardiac (atheterizatioD Services: A May to Improve
patient Care and Reduce Costs. HED-78-14; B-133044. November 17t
1977. 40 pp. s 7 appendices (16 pp.).
1,port to the Congress; by Elmer B. Staats, Comptrcller General.
Issue Area: Health Programs (1200); Health Programn: Health
Providers (1202);Health Programs: Reimbursement Policies and
utilization controls (1208).
Contact: Human Resources Div.
Budqet Function: Health: Health Care Sarvices 1551); health:
Health Planning and Construction (554).
Orqanization Concerned: Department of Defense; Department of
Health, Education, and Melfare; Veterans Administrution.
Congressional Relevance: House Committee on Armed Services;
Senate Committee on Armed Services; Congress.
AuthoritI: Economy Act (31 U.S.C. 6861. P.L. 89-7b5.
Cardiac catheterization is a procedure used ti- diagnose
pcssible heart conditions. It is performed in 90 Federal
hospitalst 66 Veteians' Idm.nistration (VA) facilities; 20
Department of Defense (DOD) iacilities; 3 Pu~li,- Health Service
hospitals; and the National Institutes of Health clinical center
in Bethesda, Maryland. Several medical professional
orqanizations, d: well as the VA, hawe developed quidelines for
cardiac catheterizAtion laboratories. These guidelines are
intended to keep physicianst skills high and to minimize risk to
patients. DOD and tho Public Health Service have no such
quidelines. Findinqs/Conclusions: The numker rf cardiac
catheterizations being performed in DOD and VA laboratories
varied considerably. For fiscal year 1976, catheterizations
performed at the Federal hospitals reviewed ranged fxc 574 at
Welter Reed in Washington# D.C., to 60 procedures at Wright
Patterson in Dayton, Ohio. Also, there was no correlation
between the number of catheterizations performed and the number
of physicians performing them. In addition, physicians at the
hospitals iad differing vievs of the number of catheterizations
that shoull be performed to maintain their proficiency. In each
of -four geographic areas visitekl, there were -.portunities to
provide cardiac catheterization on a shared basis wbich could
increase patient safety and reduce ccats to the Government. The
sharing -pportunities cou.d be accomplished within thc framework
of present laws governing DOD and VA operations.
Recommendations: Th Secretaria of Defense and Health.
Educatira, and delfare (HEN) and the Administrator cf Veterans
Affairs should: (1) jointly develop uniform Pederal guidelines
for the planning and use of Federal cardiac catheterization
laboratories which associate the numker of catheterization
procedures to be performed with the number of physicians that
should perform them; (2) consider what variances from thcse
guidelines miqht be appropriate; (3) jcintly analyze the use](ViewImageLocal?handle=hein.gao/gaobaawfj0001&div=1&collection=&method=preview&ext=.png&size=3)