Are unnecessary cardiac procedures being carried out in the Dominican Republic? An article in Hoy alerts that many cardiac stent implants may be unnecessary. Doctors suspect many procedures are to cash in on insurance coverage. They say the focus should be on prevention and early detection of cardiac problems to take other measures. While lifesaving, the cardiac procedures are costly to the health system and to patients, especially because of the costly meds the patient will need to take following the procedures.
Data from the Superintendence of Health and Labor Risks (Sisalril) reveals that in the past three years in the Dominican Republic there has been a marked increased in catheterization, angioplasties and stent implants in patients who required or supposedly required a cardiovascular procedure. The ARS paid for 20,507 procedures for a total of RD$1.7 billion. This was RD$493.9 million in 2016, RD$650.7 billion in 2017 and RD$590.3 billion in 2018.
Data from only the government health provider, Senasa reveals that in the past three years, 11,701 affiliates received 6,920 catheterizations, 4,810 angioplasties and 9,842 stent implants. The medical standard is 2.2 diagnostics per stent implanted, while Senasa numbers indicate 3.5.
The report in Hoy says this is evidence of the increase in the implanting of stents in regards to catheterizations. The concern is that while the high number of interventions is due to the greater access to health services, specialists in the area who asked to reserve their names say that the stenting could be to cash in on the insurance, despite considerations of medical ethics and quality of care.
ARS directors say that the Ministry of Public Health is not supervising the quality of the procedures. Hoy reports that in 2018, at least five new catheterization centers were opened in Moca, Santiago, San Francisco de Macoris and La Romana.
4 March 2019