Expansion of heart failure device therapy into a rural indigent population in Louisiana: potential economic and health policy implications.
BACKGROUND
Research regarding the use of implantable devices in patients with congestive heart failure (CHF) has shown mortality benefits. The Center for Medicare and Medicaid Services (CMS) approved new criteria for expanding coverage for such therapies. The purpose of this study was to determine the percentages of CHF patients in a rural, indigent heart failure population that would be eligible for implantable defibrillators (ICD) and cardiac resynchronization therapy (CRT) based on the new CMS criteria.


RESULTS
The new CMS guidelines were applied to information compiled in a database for 451 CHF disease management patients, at Leonard J. Chabert Medical Center. Results show that, annually, 32% of the newly identified CHF patient population would be eligible for ICD therapy and 7.3% would be eligible for CRT therapy.


CONCLUSIONS
Providers of health care to the indigent may lack sufficient resources for the devices and the infrastructure for device implantation and follow-up.
Hebert
Kathy
K
Leonard J. Chabert Medical Center, Houma, Louisiana 70363, USA.
McKinnie
James
J
Horswell
Ron
R
Arcement
Lee
L
Stevenson
Lynne
L
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000191:economics; D017147:Defibrillators, Implantable / Q000191:economics; D004467:Economics; D004554:Electric Countershock / Q000191:economics / Q000295:instrumentation; D005260:Female; D017048:Health Care Costs; D006291:Health Policy; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D008145:Louisiana; D008297:Male; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000191:economics; D011203:Poverty; D012424:Rural Population