On March 8, Scripps Healthcare’s Prebys Cardiovascular Institute, the largest facility on the West Coast for cardiovascular medicine, research and training, began admitting patients. The new facility combines the heart treatment capacity of both Scripps Green and Scripps Memorial La Jolla Hospitals for the Scripps system. This expansion slash consolidation was planned 10 years ago, and the new facility is designed around the decline in heart-surgery-related hospital visits requiring an overnight stay. And half a mile down Genesee Avenue, UC San Diego’s Sulpizio Cardiovascular Center, which opened in 2011, is also designed with multiple catheter labs alongside operating rooms and short-stay beds. Heart patients in San Diego have two excellent choices for their cardiac care at facilities that incorporate the latest in surgical techniques and delivery of care. But the growing trend away from heart surgeries followed by overnight hospital stays and toward outpatient catheterization procedures means that qualified post-procedure home care is more important than ever.
According to California health data, the overall number of cardiac surgeries performed in the state fell by 8 percent from 2003 through 2013, while hospital visits involving heart catheterization in San Diego County increased by 3.5 percent between 2003 and 2013. The standard of cardiac care has gradually moved from invasive open-heart procedures to non-invasive procedures using a thin metal catheter to clear blockage in the arteries. It’s even possible to replace heart valves using a catheter. And most meaningfully for cardiac patients, the percentage of these catheterization procedures that necessitate an overnight stay in the hospital has declined from 75% in 2003 to 50% in 2013. This decline is expected to continue, as Medicare and other insurance providers continue to drive a reduction in costs, and in questioning expenses like overnight stays. The role of homecare companions in this new environment will become an even more important part of the recovery process, as the new alternative to staying overnight under a nurse’s supervision in the hospital.
There’s no doubt that the face of healthcare has changed in the last 10 years, and will continue to change in dramatic ways. The overall trend in care standards leading away from unnecessarily invasive surgery and inpatient, overnight recovery means that outpatient procedures are likely to double over the next five years. Many communities around the country, especially rural communities served by a stand-alone community hospital, are losing local hospital coverage thanks to widespread closings caused by reductions in Medicare reimbursements. The fortunate residents of San Diego live in a city at the forefront of cardiac research, care and patient experience.