Evidence map›Paper›PMID 37840097›Full record

ReviewHerz2023

Healthcare provision of transcatheter aortic valve implantation in Germany.

Volker Schächinger, Dirk Elmhorst, Ralf Zahn, Christian Perings, Christoph Stellbrink, Kurt Bestehorn

Abstract readReview
PubMed Publisher
In one paragraph

Review in Herz, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Volker SchächingerMedizinische Klinik I, Herz-Thorax Zentrum, Klinikum Fulda, Fulda, Germany. volker.schaechinger@klinikum-fulda.de.
Dirk ElmhorstMediqon GmbH, Hannover, Germany.
Ralf ZahnMedizinische Klinik B, Klinikum Ludwigshafen, Ludwigshafen, Germany.
Christian PeringsMedizinische Klinik I, KLW Paulus GmbH, Klinikum Lünen, Lünen, Germany.
Christoph StellbrinkUniversitätsklinik für Kardiologie und Internistische Intensivmedizin, Klinikum Bielefeld, Bielefeld, Germany.
Kurt BestehornTechnical University Dresden, Dresden, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranscatheter aortic valve implantation (TAVI) for aortic stenosis in older patients is the standard of care with a well-established supply density in Germany. In the near future, healthcare reform is planned that may affect TAVI capacities. Therefore, it is important to know how political regulations may interfere with access to services and what the need for TAVI will be in the future, based on demographic trends.

methodsThe number of TAVI procedures (DRG F98A +F98) and the in-hospital main diagnoses of aortic stenosis (ICD I35) in 2021 were analyzed at the level of county or federal state based on anonymized data from hospital reports, according to § 21 of the German hospital reimbursement law. The number of TAVI and aortic stenosis cases was projected for 2035 based on data from the German Federal Statistical Office on demographic developments. With quality assurance data from hospitals in 2019 and a route planner, the travel time to the next hospital performing TAVI (OPS 5‑35a.0) was calculated, and the consequence of a politically suggested minimum volume cut-off was analyzed.

resultsIn 2021, a total of 26,506 TAVI procedures were reported with a mean number of TAVI per 100,000 inhabitants of 32 (range between federal states from 25 to 42). Among the 66,045 diagnoses of aortic stenosis, there was a variation per 100,000 inhabitants from 64 to 108 (mean 79) between federal states. Compared to 2021, an additional 8748 (+13%) diagnoses of aortic stenosis and an increase of 4673 (+18%) TAVI procedures is to be expected in 2035. In 2019, 57% of German citizens could reach a TAVI hospital within 30 min and 91% within 60 min of driving time by car (mean time to hospital 31 min). Applying a minimum number of 150 TAVI/hospital per year would increase the driving time to hospital from 33 to 52 min in Saxony-Anhalt and instantly remove six out of eight hospitals from service in Hesse.

conclusionRegulation of TAVI services by minimum volume numbers would arbitrarily interfere with access to services, in contradiction to the medical service assurance tasks of federal state governments. These issues should be considered in the upcoming healthcare system reform.

Indexed as

Aortic Valve StenosisHeart Valve Prosthesis ImplantationTranscatheter Aortic Valve ReplacementAgedAortic ValveDelivery of Health CareGermanyHumansRisk FactorsTreatment OutcomeAortic stenosisAortic valveHealthcare provisionHealthcare reformHospitals, minimum volume

Identifiers

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.