Hospital Takes Heart From New Unit’s Success : Medicine: The business of cardiac care is booming at Downey Community Hospital. This year, 355 angioplasties and cardiac surgeries have been performed, an 8.8% rise over ’89.
Cardiologist Winfried Waider maneuvered the guide wire through a main artery to the blockage that caused his patient severe chest pain by restricting the flow of blood to her heart.
One, two, three, four times the tiny balloon was inflated, smashing down years of plaque buildup and blood that had clotted in the artery.
The angioplasty cleared the artery and, minutes later, another patient was rolled into the high-tech lab at Downey Community Hospital for an exploratory heart procedure. Three more patients would follow before the workday ended.
Business is booming at the hospital’s Heart Center, which opened in the highly competitive Los Angeles area market just three years ago.
So far this year, 355 angioplasties and heart surgeries have taken place at the 207-bed hospital, said the hospital’s administrative director, Tom Lonergan. That represents an 8.8% increase over the number of angioplasties and heart surgeries performed in all of 1989. Cardiologists also performed 758 diagnostic catheterizations, an exploratory procedure in which a catheter is inserted and maneuvered through an artery to the heart.
“We’d never thought we’d be doing the kinds of numbers we’re doing now, in our wildest dreams,” Lonergan said.
The upstart heart program still has a way to go before it challenges the big boys: The Hospital of the Good Samaritan in Los Angeles, for example, had 663 angioplasties and 2,978 diagnostic catheterizations in 1988, to lead all hospitals in California, according to statistics published by the California Office of Statewide Health Planning and Development.
Downey Community ranked 83rd in the number of angioplasties performed that year, its first full year of operation and the latest year for which statewide statistics are available.
“I don’t know that we’ll ever have the volume that a Good Sam’ has, but we have the potential of increasing our numbers and becoming a bigger player,” Lonergan said.
The heart center has contributed to the rising income the nonprofit hospital has enjoyed in recent years, Lonergan said. The hospital netted $1.9 million during its 1988 fiscal year and $4.1 million in 1989, according to a hospital report. That figure is expected to reach $6.4 million for the 1990 fiscal year, which ended June 30, a hospital spokeswoman said.
The success of the heart-care program has drawn outside notice. Larry S. Stepnick, a spokesman for the Health Care Advisory Board, said: “Downey is in a very elite group of small, relatively ‘unknown’ hospitals which have been able to begin a successful cardiology program in the last few years, and perhaps the only one to do so in a market as competitive as that of Los Angeles.”
The Advisory Board, a Washington-based firm, performs studies each year to inform 450 hospitals across the nation about techniques that can increase profits.
The Downey hospital will be profiled, along with others, in an Advisory Board study on cardiology programs. Stepnick said Downey Community offers “high quality at a competitive price.”
Heart care has become a plum business for hospitals that break into the market and run a successful program. Lonergan said heart care generally provides about 17% of a hospital’s gross revenues, but up to 50% of its profits.
Marketing studies indicated that the Heart Center would be profitable, Lonergan said: “The community was really wanting it. You obviously would rather have major types of surgery performed in your community, with people you know, rather than travel long distances.”
Downey Community spent more than $6 million to build and equip its center, which opened Sept. 23, 1987.
The idea was to couple top-notch service with aggressive marketing, which included an eye-catching billboard along the Santa Ana Freeway that featured a 16-foot-high latex heart that beat by means of motors and fans.
The hospital had relied on a core group of eight cardiologists for advice on how best to outfit the center, Lonergan said.
The lab, where the angioplasties are performed, was built next to the operating room so open-heart surgery can be performed quickly if complications develop.
The lab is equipped with the most modern digital X-ray equipment, which has helped attract about 30 cardiologists and their patients to the hospital.
“They provide us with what we want and need,” said cardiologist Stephen N. Berberich, one of the doctors who helped plan the facility.
Most standard cardiac procedures are performed at Downey Community, including bypass surgery and valve replacements. Hospital charges for an angioplasty start at about $3,500, while heart surgery carries a hospital fee of $12,000 and up, a hospital spokeswoman said. Doctor fees, which vary widely, are additional.
The heart center has a good success rate. The number of deaths of patients with heart problems is well within the expected range, according to the federal Health Care Financing Administration.
For example, the mortality rate for patients with severe, chronic heart disease was 15.4% in 1988 at Downey Community. The predicted mortality range for the hospital’s clientele, based on demographic factors, was 9.8% to 33.8%, according to an HCFA report.
“Like anything in business, you have to have the quality to be successful,” Lonergan said. “That’s been our focus.”
Cardiologists at neighboring hospitals praised the heart program at Downey Community because it provides top-notch, standard heart care to the community. But they also noted the limits of the hospital’s program.
For example, Downey Community uses the time-tested angioplasty. The hospital does not perform atherectomies, which are several experimental procedures that remove plaque from arteries by scraping, drilling or pulverizing. Usually, such high-technology procedures are limited to research hospitals, such as Good Samaritan.
An atherectomy was performed last month on Dan Reeves, coach of the National Football League’s Denver Broncos, who had hardened arteries. It took place in Redwood City, San Mateo County.
Downey Community is “a prototype for what a community hospital giving cardiac services should be like,” said Dr. Stephen Oesterle, director of catheterization labs at Good Samaritan.
Dr. John Messenger, director of the coronary care unit at Memorial Hospital Medical Center, Long Beach, has watched Downey’s heart program grow for three years. His partner, cardiologist Waider, performs some of his angioplasties there.
“They’ve taken some of our business away, but it’s probably better for patients if they are closer to home,” Messenger said.
