IOM: Cardiac Arrest Survival Rate Low; Access to Care Issues Remain
The survival rate for U.S. residents who go into cardiac arrest outside of a hospital is unnecessarily low, and new strategies should be implemented to target the issue, according to a report released Tuesday by the Institute of Medicine, Modern Healthcare reports (Rice, Modern Healthcare, 6/30).
Cardiac arrest is a disruption in the mechanical or electrical activity that runs the ordered pumping of blood from the heart. Typically, it results in a sudden collapse (Bernstein, "To Your Health," Washington Post, 6/30). Cardiac arrest is the third-leading cause of death for U.S. residents, according to IOM (Sapatkin, Philadelphia Inquirer, 7/1).
IOM noted in the report that about 600,000 U.S. residents experience cardiac arrest each year. About 400,000 of such incidents occur outside of a hospital.
The survival rate for cardiac arrest at a hospital is 24%, while the survival rate is less than 6% when the incident occurs outside of a hospital. Further, a study of 10 sites in North America found that the survival rate for incidents that occur outside of hospital varies by location, ranging from 7.7% to 39.9%.
About 46% of cardiac arrests that occur outside of hospitals are witnessed by another individual. Individuals experiencing cardiac arrest often do not respond to electrical shock, largely because the defibrillator did not arrive in time. Meanwhile, less than 3% of the population receives training in cardiopulmonary resuscitation each year, according to the authors ("To Your Health," Washington Post, 6/30).
In addition, the researchers noted that many U.S. residents do not know what cardiac arrest is. They said the term is often used interchangeably with "heart attack," though the two do not mean the same thing (Philadelphia Inquirer, 7/1).
Report Outlines Issues
The report states, "The ability to consistently deliver timely interventions and high-quality care is less than impressive," adding, "The result is too many people dying from cardiac arrest." The authors noted that boosting cardiac arrest responses in the U.S. is hindered by inadequate data and relatively low research spending, compared with other diseases ("To Your Health," Washington Post, 6/30).
The report offers strategies in six areas to address cardiac responses, including:
- Establishing a national cardiac arrest registry;
- Boosting emergency medical system performance;
- Improving care systems;
- Promoting reach and innovation;
- Better educating the public about CPR and defibrillator use; and
- Creating a national collaborative to make goals for survival improvement (Rice, Modern Healthcare, 6/30).
Report: Scheduling Contributes to Access Issues
In related news, access to care issues persist in the U.S., in part because of an appointment scheduling system that aligns with providers' convenience and practices that do not properly use nurse practitioners and physician assistants, according to an IOM report released Monday, Modern Healthcare reports.
The report was funded in part by the Department of Veterans Affairs, following a scandal that exposed long wait times for appointments.
The report is a follow-up to a 2001 IOM report that noted six characteristics of high-quality health care:
- Safety; and
The new report found that, of those traits, researchers have done the least research on timeliness and therefore have the lowest understanding of the issue.
In the report, IOM noted that care delays can have significant consequences for patients with:
- Joint problems;
- Kidney disease;
- Mental health issues; and
- Substance use disorders.
The authors wrote, "The health care system currently reflects mainly the priorities of providers and organizations, which has resulted in a focus on traditional scheduling systems that have not been engineered to engage or satisfy patients, but that instead are designed to fit a staff schedule that may be poorly aligned with patient perspectives or circumstances."
The authors recommended that primary care physicians refer a patient to another provider if they are unable to see the patient within 48 hours (Robzenieks, Modern Healthcare, 6/30).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.