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SCAI consensus paper defines length of stay post-PCI
The paper is to help clarify same-day PCI terminology and help physicians make decisions about when to discharge patients undergoing elective PCI.
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A physician can determine a patient’s length of stay following percutaneous coronary intervention with the help of four newly created categories, according to a new consensus paper from the Society for Cardiovascular Angiography and Interventions.
“The goal of this paper is to help physicians’ care of patients,” said Charles E. Chambers, MD,of Pennsylvania State University Hershey Medical Center, Hershey, Pa., during a SCAI press conference yesterday.
The authors identify the four categories of elective PCI as Outpatient, Observation <24 hour, Extended Observation and Inpatient Admission. The purpose is to help guide physicians in deciding what a patient’s length of stay should be based on health criteria, but also considering healthcare costs.
“[I]t was the goal of this Expert Consensus Panel to examine current practice standards for PCI in the United States and propose a rational scheme that would maintain patient safety and quality in PCI, yet also reduce unnecessary expenditures,” the panel wrote.
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Outpatient PCI includes patients who are clinically stable prior to the procedure, and do not have clear complications while undergoing PCI. They are briefly observed before being discharged. Under the Observation <24 hour category, patients would require more observation but still less than a full day. Patients stay overnight and are observed for possible complications. Extended Observation means patients require ≥24 hours of observation but not a full hospital admission. Inpatient Admission inclues “patients admitted with STEMI, non-STEMI or an unstable ACS manifested by transient ischemic ECG changes or hemodynamic instability,” according to the paper.
“We hope to clarify any confusion about the terminology that is used in defining same-day elective PCI procedures. Terminology varies around the country and for different insurance providers,” said Gregory J. Dehmer, MD, a co-author of the consensus and of the cardiology division of Texas A&M Health Science Center, College of Medicine, and the cardiology division of Scott and White Healthcare, Temple, Texas.
The paper also strives to help physicians understand the changes in reimbursement relating to elective PCI and ambulatory hospital stays. “There are reimbursement issues that exist and recent shifts in reimbursement for elective PCI procedures,” Dehmer said. “Our concern first and foremost is for patients.” – by Judith Rusk
For more information:
- Chambers CE. CatheterCardiovasc Interv. 2009;doi:10.1002/ccd.22100