TAVI In South Africa's resource-constrained economy: the role of local data in overcoming funding resistance
| العنوان: | TAVI In South Africa's resource-constrained economy: the role of local data in overcoming funding resistance |
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| المؤلفون: | Mpiko Ntsekhe, Jacques Scherman, Hellmuth Weich, Share-Tavi Investigators, E Schaafsma |
| المصدر: | European Heart Journal. 41 |
| بيانات النشر: | Oxford University Press (OUP), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | New York Heart Association Classification, business.industry, Resource constrained, Development economics, Medicine, Resistance (psychoanalysis), Cardiology and Cardiovascular Medicine, Private sector, business, Biological sciences, Health policy |
| الوصف: | The South African (SA) prospective multi-centre observational SHARE-TAVI registry aims to provide local outcomes data on all TAVIs in State & Private sectors, to support local evidence-based policy evaluations, comparing outcomes to international data & identifying local variations. Methods and results All 14 implants centres voluntarily capture data into the web-based SHARE-TAVI registry. 1375 patients from Sept 2014-Jan 2020 had pre-TAVI clinical evaluations, 998 proceeded to TAVI & procedural data & complications recorded (VARC-2 criteria), 30d & annual follow up. State sector hospitals provide limited tertiary cardiac care due to severe resource constraints. 13% of TAVIs in SA are in State teaching hospitals, 6.2% of State implants are 2nd generation (2G) devices. In the Private sector the roll-out of TAVI is inhibited by funding resistance, particularly to higher-cost 2G valves. 1st generation (1G) implants comprise 30% of 2019 implants, funding policies leave patients with unaffordable co-payments for 2G valves. Local data (Table 1) shows peri- & 1-year mortality, & procedural success (average 95.4%, & in 2019 98.91%), which are comparable with international data. TAVI in SA is successful despite low volumes & resource limitations. Local data supports superiority of 2G over 1G i.t.o this data and hospital stay length, & unplanned valve-in-valves. No significant differences between 1G & 2G in re-admissions in year 1, but improved quality of life patients experience with TAVI implantation is notable in the NYHA class. Funding Acknowledgement Type of funding source: Other. Main funding source(s): SA Heart Association registry project funding. Unrestricted educational grants by Medtronic and Edwards Life Sciences |
| تدمد: | 1522-9645 0195-668X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::55baa6e43ae9e81fd10b2de2f6fd54cc https://doi.org/10.1093/ehjci/ehaa946.3528 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi...........55baa6e43ae9e81fd10b2de2f6fd54cc |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15229645 0195668X |
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