Summary: Cardiac catheterization is a procedure used to diagnose possible heart conditions. It is performed in 90 Federal hospitals: 66 Veterans' Administration (VA) facilities; 20 Department of Defense (DOD) facilities; 3 Public Health Service hospitals; and the National Institutes of Health clinical center in Bethesda, Maryland. Several medical professional organizations, as well as the VA, have developed quidelines for cardiac catheterization laboratories. These guidelines are intended to keep physicians' skills high and to minimize risk to patients. DOD and the Public Health Service have no such guidelines.
The number of cardiac catheterizations being performed in DOD and VA laboratories varied considerably. For fiscal year 1976, catheterizations performed at the Federal hospitals reviewed ranged from 574 at Walter Reed in Washington, D.C., to 60 procedures at Wright Patterson in Dayton, Ohio. Also, there was no correlation between the number of catheterizations performed and the number of physicians performing them. In addition, physicians at the hospitals had differing views of the number of catheterizations that should be performed to maintain their proficiency. In each of four geographic areas visited, there were opportunities to provide cardiac catheterization on a shared basis which could increase patient safety and reduce costs to the Government. The sharing opportunities could be accomplished within the framework of present laws governing DOD and VA operations.
