How do you start to transform the long ingrained opinions that heart disease affects primarily men? Most people are surprised when told that not only is heart disease the #1 killer of women, but that more women die from heart disease than breast cancer. According to the American Heart Association, nearly 500,000 women die each year from heart disease.1 And although today's advances in cardiology are many, 38% of women will die within one year of a first heart attack. Clearly, we can and should do a better job at treating women with heart disease.
These facts haven't gone unrecognized by the healthcare community, who produces a wealth of educational literature, websites, and symposiums focusing on women's heart care. Additionally, new and established heart centers are beginning to concentrate on cardiac issues specific to the care of women. These efforts do demonstrate favorable steps for progress, but more is needed to reduce the alarmingly high mortality rate. Recent research reveals a disparity between the cardiac treatments given to females vs. males. The dramatic improvements in pharmaceuticals, time to treatment, interventional cardiac catheterization, and cardiovascular surgery aren't consistently applied to both genders.
Resolving inequities
The following organizational steps can be useful in resolving cardiac care inequities:
♦ Begin at the organizational level by providing educational programs to your nursing staff and physicians with topics such as:
--the prevalence of heart disease among women
--identification of cardiac symptoms in women
--primary prevention methods
This fundamental intervention that is a vital foundation to affect a change in medical practice that can save women's lives.
♦ Formulate a community awareness program to address issues on the following:
--risk factor identification specific to women
--risk factor reduction methods specific to women
--identification of cardiac signs and symptoms specific to women
--discussion topics with your physician
--cardiac screenings.
Hospitals offering these programs report capacity attendances and waiting lists for sessions, supporting evidence that there's need and interest. The programs serve two objectives: providing a needed educational opportunity for the women in your community and showcasing your cardiac services.
Developing a program
Since cardiac disease is a chronic condition, a disease management model proves suitable. Develop organizational strategic initiatives to provide continuous services that will significantly impact this condition. (See "Sample outline.")
Trendsetter programs are paving the path for others to follow by providing proof of the clinical and financial benefits to offering a cardiac program specific to women. Research on the profitability of women's cardiac programs demonstrates a favorable bottom-line impact. Additional non-cardiac diagnostic testing is reported to increase as a result of these programs. This research provides the evidence of the value of directing organizational efforts toward provision of women's cardiac services.3
For many years it has been known that women are the primary decision makers in healthcare. Hospitals have responded to this by developing women's health centers that address OB/Gyn needs, screening for osteoporosis, and breast care. These programs were developed to meet what was considered to be the most pressing health issues for women, but by continuing to offer only these services they fail to address heart disease. Seize the opportunity to become a "full service" women's health program by providing women's cardiac services.
REFERENCES
1. American Heart Association: Heart Disease and Stroke Statistics-2003 Update. Dallas, Tex.: American
Heart Association, 2002.
2. Heartwire: Women with heart disease are "substantially undertreated," Theheart.org; Jan. 20, 2003.
3. The Advisory Board Company: Cardiovascular Roundtable. Enterprise in Transition, National Membership Meeting, Washington, D.C., 2002.