Delivering quality healthcare ?

Healthcare in India has undergone a tremendous transition in the past few years with rapidly changing disease patterns. What holds paramount significance in the background of this transition is the prioritization of providing quality healthcare to patients. Access to quality healthcare is at the core of efficient prevention and management of the disease burden.

This is particularly relevant in India as the country bears a staggering 21% of the world's disease burden. I am saying this because as a cardiologist, I can see the growing burden of heart diseases posing a huge challenge in the country. Ischemic heart disease and stroke are the predominant causes and are responsible for more than 80% of CVD (cardiovascular diseases) deaths.

Fortunately, tech innovation and research are creating new path-breaking products with safer and far better devices available to treat heart patients. Today, angioplasty is a safe and predictable treatment for heart disease. We have enough data to prove that the use of coronary stents in necessary conditions has reduced the number of patients dying from heart attacks and has raised the chances of surviving a sudden cardiac arrest manifold.

I would also like to emphasise that the real benefits of advanced technology can be transferred to patients only when all clinical decisions are based on necessary patient safety and quality guidelines.

According to me, enhancing quality of care would require interventions at all stages of the treatment process. In the case of cardiology, particularly, while using implants, patient safety is a major concern as the implant will stay in the body forever. Therefore, ensuring the right treatment plan according to patient conditions and using the most appropriate quality of stent is a critical factor in determining desired patient outcomes.

Once it is established that a patient needs stent, it is vital to use a stent which has been verified and well researched. I would like to highlight that using stents with less clinical backing may lead to certain complications like increasing the risk of recurrence of abnormal narrowing of an artery, altering the diagnosis of the heart disease and repeat procedures.

Moreover, such stents are also said to prolong the recovery time of a patient and pose an acute problem of delivery of the stent, making the trackability difficult.

Today, majority of the cardiologists prefer implanting Drug-Eluting Stents (DES - coated with medicine that is slowly released into the artery to treat the diseased area) because of their proven efficacy. We need to be sharp-sighted when it comes to the quality of stents.

Thus, it becomes important that the stent selected for placement is backed by ample clinical data as it reduces the risk of complications. In this regard, DES have shown better patient outcomes as they have been proven to be efficient by robust data. What we need to realise is that ensuring compliance with quality benchmarks and guidance of products helps achieve long-term lifecycle management.

Here, the lifecycle of a USFDA-certified stent has been observed to be much longer due to the rigorous approval process. With patient care as the foundation, doctors choose such well-tested stents which are validated through certifications.

I would like to point out here that if the patients themselves or caregivers are well-informed, then the best treatment outcomes can be achieved. In my practice, I have always ensured that the patient is aware of all the available options before undergoing any treatment. Although prescribing the most appropriate mode of treatment is the onus of the treating physician, patients need to be equally involved to make a decision for quality treatment.

Evidently, health is one of the most essential factors for human development and every healthcare system must fulfill certain fundamental objectives to ensure holistic delivery of care. When it comes to expanding access to quality healthcare to its citizens, India is at a crossroads. This can be attained by giving due importance to factors of patient safety and ensuring healthcare quality. In the current scenario, when quality related issues have been observed across healthcare services, it is time that emphasis is put on the need for safety guidelines with patient's quality of life at the core.

(The writer is former professor in KMC Manipal, Senior Interventional Cardiologist in Manipal Hospital, Bengaluru)

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