Jesus Casado Cerrada, Coordinator of the Heart Failure and Atrial Fibrillation Working Group (ICyFA).
Recently, several voices emerged from hospital experts urging the restoration of continuity of care for heart failure patients, who have been interrupted as a result of the Covid-19 pandemic, warning that if this does not happen,e will pay with more hospital admissions. Some of the increases reported by the Heart Failure Group of the Spanish Society of Internal Medicine (SEMI) indicate a lack of official data, although they recognize that “feeling” Is this what I knowlive more income, Especially in those areas where There is no specific unit Which avoids the usual circuit of ER for cardiology and cardiology.
“It is true that in chronic diseases with structured, specific follow-up that relied on some specialists and primary care physicians, the epidemic of course contributed to the fact that structured follow-ups could not be performed because they were pre-conditioned,” says Jesus Casado Cierada, coordinator of the Heart Failure and Atrial Fibrillation Working Group. , the expert remembers it no proof That this had a real impact on Increase in hospital admissions for this disease. Although he claims it “Yes, it is true that sensation and perception exist.”
This loss of continuity, as detailed by Casado Cerrada, in the field of heart failure must be very precise: “The follow-up of these patients is heterogeneous in the sense that there are many patients with heart failure who receive treatment. Monitoring in multidisciplinary and specific units organized by hospitals with and without primary care ties.”
Should they receive this kind of assistance, the expert is of the opinion that their follow-up has not diminished because “there are resources and accessibility to ensure this follow-up.” However, it is not something that extends across Spanish territory. “There are patients who were not admitted to these units and, therefore, may have seen this low follow-up.”
A differentiated circle of patients who come to certain units
The key to whether or not to maintain follow-up care lies in Differentiation in the circle of care through which the patient passes. “Those who go to these units often don’t go through a hospital emergency, where they have direct access through telephone consultations and nurses and doctors who specialize in heart failure,” the doctor explains. So for Casado Cerrada, these units are a form of Follow-up guarantee Closer to the patient by not following the usual circuit and going to these units over the phone.”
differentiation of circles that Made a difference during the toughest phase of the epidemic. “Covid really took over 90 percent of the resources and patients with other illnesses did not go to the emergency room. In that sense, if they were in units it doesn’t matter because continuity of care is guaranteed through direct access. If they are not there, it is because they have not been Diagnosed with heart failure or because that healthy area does not have this structure.. These patients were able to see themselves conditioned or directly affected They didn’t receive the help that Covid would have if they would have,” The specialist confirms.
Communication between cardiologist, trainee and nursing
The other issue questioned is Smooth communication between hospital staff. In this sense, Casado Cerrada emphasizes that the situation is very heterogeneous in Spain and in many Western countries. for this reason It varies a lot depending on the organization Hospital and health district.
“At Getafe Hospital we have a multidisciplinary assistance structure with the same team of cardiologists, internists, nurses who specialize in heart failure, continuity of care, emergency room doctors and even palliative care doctors. Our structure is very well organized and communication Completely seamless between all team members”, details the specialist, who alludes to a ‘more difficult connection’ where this is Infrastructure does not exist.
For this reason, Casado Cerrado hopes that these models of structured, multidisciplinary assistance will be “the way to go for everyone.” “Today, this path is not universal. Currently, we are in the middle of the road, but we are not worse off than the countries around us. I think we are leading the way along with other leading countries,” explained the internist, who also remembers that cardiology and internal medicine agreed on consensus document three years ago How should you organizeAnd the. I think there is little documentation of this style. Now it is necessary to direct her to help, which is the most complicated matter ”, he concludes.
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