Symposium Explores the Quality Versus Access Dilemma

international-3Bringing quality cardiothoracic surgical care to underserved regions is rife with challenges. Managing costs, staffing, training, equipment needs, and follow-up care are overwhelming concerns. These are compounded when a lack of access hinders patients from getting treatment. Quality, access, financial, and ethical considerations also are paramount issues when providing cardiothoracic surgical care in the midst of a humanitarian crisis.

The International Symposium will examine the quality versus access debate for underserved regions and for countries responding to refugees who have fled en masse.

In two talks, presenters will compare the costs and benefits of regionalized cardiothoracic surgical care and localized care in lower-volume centers.

“Speakers will discuss centers of excellence for very difficult procedures, but people in some areas of the world have a great distance between where they live and where they can access care,” said moderator A. Pieter Kappetein, MD, PhD, of Erasmus Medical Center in Rotterdam, the Netherlands. “This is not limited to developing countries. It is also true for the Western world. You can strive for the best and the most excellent center of excellence, but that’s not always possible.”

A. Pieter Kappetein, MD, PhD

A. Pieter Kappetein, MD, PhD

Although some argue that low-volume centers have good outcomes, others say highly specialized centers are needed because cardiac surgery patients are complex, Dr. Kappetein said. The speakers will share their experiences setting up sustainable specialized centers in Nepal and South Africa.

Another speaker will give his take on the quality, access, financial, and ethical challenges involved in the Syrian refugee crisis. “About 65 million people have been displaced from their homes; 21.3 million of them are refugees for whom flight is virtually necessary—involuntary victims of politics, war, or natural catastrophe. We will discuss potential challenges that we face in how we as surgeons can help,” Dr. Kappetein said.

The session will conclude with a presentation on the global challenge of treating noncommunicable diseases, including cardiothoracic diseases.

“The speaker will explain how cardiac disease is becoming a very relevant issue in Africa and in developing countries,” Dr. Kappetein said.

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