Transcript Slide 1

An Investigation into the Effects of Opening
a Cardiac Centre in Middlesbrough
Neil Macknight
Senior Information Manager
Background
• Pre 1993- Cardiac Centre at Freeman Hospital, Newcastle
• Perceived geographical bias for specialised cardiac treatment
• 1993- Additional Cardiac Centre opened in Middlesbrough
What was the impact of the opening of the Middlesbrough
cardiac centre on Revascularisation rates?
Methodology
• Numerator- HES Data for Revasc Procedures 1989-1997
• Proxy indicator for need- HES Admissions for IHD
• Proxy indicator for need- Deaths from IHD 1989-1997
• Population Data: PROBLEMS
Before opening Middlesbrough
Cardiac Centre
Revascularisations in 89-90 to 91-92 (sq rt)
30
25
Newcastle
20
North Tyneside
15
Blyth Valley
10
Castle Morpeth
Sunderland
Gateshead
Redcar & Cleveland
Middlesbrough
5
0
0
10
20
30
40
MI admissions in 89-90 to 91-92 - revascs (sq rt)
50
60
After opening Middlesbrough
Cardiac Centre
30
Revascularisations in 94-95 to 96-97 (sq rt)
Redcar & Cleveland
25
Middlesbrough
Sunderland
20
Hartlepool
15
South Tyneside
Darlington
Durham
10
Tynedale
Chester-le-Street
Berwick
5
0
0
10
20
30
40
MI admissions in 94-95 to 96-97 - revascs (sq rt)
50
60
Geography
Deprivation
80
Deprivation quintile 1
Deprivation quintile 2
Deprivation quintile 3
70
Deprivation quintile 4
Deprivation quintile 5
60
50
40
30
20
96-97
95-96
94-95
93-94
92-93
91-92
0
90-91
10
89-90
Rate of revascularisations per 100 MI admissions
90
Revascularisation Provision
2005/06 (Provisional HES Data)
Observed revascularisation rate per million
population
2,200
Langbaurgh
Middlesbrough
2,000
NSF target
adjusted for need
Gateshead
1,800
Durham &
Chester-le-Street
Sunderland
Durham Dales
South Tyneside
1,600
Northumberland
North Tees
1,400
1,200
Derwentside
Easington
Darlington
Sedgefield
North Tyneside
Newcastle
Hartlepool
1,000
1,
0
50
1,
0
60
1,
0
70
1,
0
80
1,
0
90
2,
0
00
Expected revascularisation rate per million population
2,
0
10
2,
0
20
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Patient Flow
2005/06 (Provisional HES Data)
100%
90%
80%
70%
60%
50%
Others
James Cook
40%
Freeman
30%
20%
10%
0%
Next Steps
• Journal Paper
• Drive time analysis
• What next?