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Maharashtra Plans Hub-and-Spoke Model to Boost Cardiac Care

Giving a boost to the early diagnosis and treatment of cardiac ailments, the upcoming Maharashtra health Budget plans to strengthen catheterization laboratories and electrocardiography (ECG) services in government hospitals. Once implemented, a patient who suffers a cardiac emergency, such as a heart attack, will have to travel no more than 50 km to seek basic treatment. Inspired by the Tamil Nadu government, the Maharashtra government has presented its proposal under the National Health Mission for a state-wide hub-and-spoke model for treating heart patients. In the hub-and-spoke model, the state government plans to have an ECG facility in 30 to 100-bedded hospitals that will act as spokes. In an emergency, a patient’s ECG report will be sent online for a district doctor’s opinion. In serious cases, for instance when a patient suffers a heart attack, he or she will be referred to a central hub — medical colleges or civil hospitals — for further investigation or angioplasty.

Discussions are also underway on whether to rope in hospitals empanelled under the Pradhan Mantri Jan Arogya Yojana (PMJAY) and Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) for acting as hubs. “In a year, we will slowly increase our capacity of cath labs and more ECG machines,” said Dr Satish Pawar, joint director at Directorate of Health Services (DHS). According to DHS data, Maharashtra records 300-500 cardiac-related medical emergencies every day. But the government caters to half the medical emergencies with over 200 ECGs recorded daily across government hospitals. Heart ailments have become the top-most killer, jumping from fifth most-common cause of death in 2005 to top-most in 2016, Pawar said. Of 1500 medical emergencies that the 108-emergency ambulance caters to, 20 percent are cardiac-related emergencies. The plan is to prevent deaths due to cardiac problems by diagnosing and treating them early. “While the ECG facility is available in several of our primary health centers, immediate treatment in case of heart attack becomes difficult,” said principal secretary (health), Dr Pradeep Vyas. He added that the proposal awaits final approval. The Center and state will share the cost in 60:40 ratio. – Indian Express

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