McGill Adult Unit for Congenital Heart Disease (MAUDE Unit), McGill University Health Center, Montreal, Quebec, Canada.
Prog Cardiovasc Dis. 2011 Jan-Feb;53(4):239-46. doi: 10.1016/j.pcad.2010.10.001.
Advances in pediatric cardiology and cardiac surgery have resulted in a change in the mortality, prevalence, and age distribution of patients with congenital heart disease (CHD). In this chapter, we review the changing epidemiology of CHD and the impact of these trends on health services utilization and delivery in this population. We demonstrate not only that adult CHD (ACHD) patients have high utilization rates but also that care gaps exist where disease is expected to be lifelong. We outline the components of quality improvement for the care of ACHD patients. We review the newly published guidelines for the management of CHD conditions in adults, anchoring them to structure, process, and outcome indexes of quality of care. We highlight the manpower needs and the importance of an appropriately trained cardiology workforce to provide ACHD care. Finally, we review recommended health care systems ideally suited to deliver care to this population.
儿科心脏病学和心脏外科学的进步改变了先天性心脏病 (CHD) 患者的死亡率、患病率和年龄分布。在本章中，我们回顾了 CHD 的变化趋势及其对该人群卫生服务利用和提供的影响。我们不仅证明了成人先天性心脏病 (ACHD) 患者的利用率很高，而且还存在预期是终身性疾病的护理差距。我们概述了 ACHD 患者护理质量改进的组成部分。我们回顾了新发布的成人 CHD 管理指南，将其与护理质量的结构、过程和结果指标联系起来。我们强调了人力需求以及培训有素的心脏病学劳动力的重要性，以提供 ACHD 护理。最后，我们回顾了建议的卫生保健系统，这些系统最适合为该人群提供护理。
