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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:567-75 - Vol. 70 Num.07 DOI: 10.1016/j.rec.2017.03.022

The RECALCAR Project. Healthcare in the Cardiology Units of the Spanish National Health System, 2011 to 2014

Andrés Íñiguez Romo a, Vicente Bertomeu Martínez b, Luis Rodríguez Padial c, Manuel Anguita Sánchez d, Francisco Ruiz Mateas e, Rafael Hidalgo Urbano f, José Luis Bernal Sobrino g, Cristina Fernández Pérez h, Carlos Macaya de Miguel i, Francisco Javier Elola Somoza j,

a Servicio de Cardiología, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
b Servicio de Cardiología, Hospital de San Juan, San Juan de Alicante, Alicante, Spain
c Servicio de Cardiología, Complejo Hospitalario de Toledo, Toledo, Spain
d Servicio de Cardiología, Hospital Reina Sofía, Córdoba, Spain
e Servicio de Cardiología, Hospital Costa del Sol, Málaga, Spain
f Unidad de Gestión Clínica de Cardiología y Cirugía Cardiovascular, Hospital Universitario Virgen Macarena, Sevilla, Spain
g Servicio de Control de Gestión, Hospital Universitario 12 de Octubre, Madrid, Spain
h Unidad Transversal de Apoyo a la Investigación, Hospital Clínico Universitario San Carlos, Madrid, Spain
i Servicio de Cardiología, Hospital Clínico Universitario San Carlos, Madrid, Spain
j Elola Consultores, Fundación Instituto para la Mejora de la Asistencia Sanitaria, Madrid, Spain

Keywords

Quality. Efficiency. Performance.

Abstract

The RECALCAR project (Spanish acronym for Resources and Quality in Cardiology Units) uses 2 data sources: a survey of cardiology units and an analysis of the Minimum Basic Data set of all hospital discharges of the Spanish National Health System. From 2011 to 2014, there was marked stability in all indicators of the availability, utilization, and productivity of cardiology units. There was significant variability between units and between the health services of the autonomous communities. There was poor implementation of process management (only 14% of the units) and scarce development of health care networks (17%). Structured cardiology units tended to have better results, in terms of both quality and efficiency. No significant differences were found between the different types of unit in the mean length of stay (5.5 ± 1.1 days) or the ratio between successive and first consultations (2:1). The mean discharge rate was 5/1000 inhabitants/y and the mean rate of initial consultations was 16 ± 4/1000 inhabitants/y. No duty or on-call cardiologist was available in 30% of cardiology units with 24 or more beds; of these, no critical care beds were available in 45%. Our findings support the recommendation to regionalize cardiology care and to promote the development of cardiology unit networks.

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1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved