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March 16, 2005

Regionalization of Care for Acute Coronary SyndromesMore Evidence Is Needed

Author Affiliations

Author Affiliations: Section of Cardiovascular Medicine (Mr Rathore and Dr Krumholz), Robert Wood Johnson Clinical Scholars Program (Dr Krumholz), Department of Internal Medicine and Section of Health Policy and Administration, Department of Epidemiology and Public Health (Drs Epstein and Krumholz), Yale University School of Medicine and Center for Outcomes Research and Evaluation, Yale-New Haven Hospital (Dr Krumholz), New Haven, Conn; Department of Medicine, School of Medicine, University of Pennsylvania, Philadelphia (Dr Volpp); and the Veterans Affairs Center for Health Equity Research and Promotion, Philadelphia, Pa (Dr Volpp).

JAMA. 2005;293(11):1383-1387. doi:10.1001/jama.293.11.1383

There is a growing movement advocating the treatment of patients with acute coronary syndromes (ACS) at regional centers with dedicated facilities.1,2 Proponents contend that regionalized ACS care will save lives by improving access to new technologies, specialist physicians, and higher-quality care not available at other centers.1,2 The state of Maryland has already begun planning for regionalized care for patients with ACS.3 Recent enthusiasm for this movement has focused on its potential benefits. In this article, we present concerns about the rationale for regionalized ACS care and outline some potential unintended consequences.

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