Background: The establishment of specialty vein clinics has proven beneficial in terms of expansion of clinical volume. Depending on the local situation, the creation of a venous surgical centre may, in addition, result in better collaboration between various specialties, enable active participation in the development and evaluation of new treatment modalities, offer better training/education and provide venues for more complex treatment modalities such as reconstructive surgery of the deep venous system. Objectives: The aim of this study was to analyse the impact of the creation of a venous surgical centre under the auspices of a department of cardiovascular surgery at a university hospital. Methods: A venous surgical centre was established on 1 October 2003, under the direction of one senior surgeon. The impact on clinical activity was measured in terms of patient volume, percentage distribution between venous and arterial surgery and surgical procedures performed, complications following venous surgery as well as evaluation of patient and referring physician satisfaction. Data, from the department's databank, on all patients evaluated and surgically treated for venous and arterial problems from 1 January 2000 to 30 June 2006 were analysed. Number of outpatient clinic visits and operations (patients and surgical procedures) were calculated. Results: The establishment of the venous surgical centre, without additional funding, led to a significant increase in clinical volume. There was a 433% increase in vein surgical procedures and a 774% increase in outpatient clinic visits (comparing 2002 with 2004). Endovenous laser treatment of varicose veins and reconstructive surgery for the deep venous system was started, and a program for training surgeons was established. Complication rate following varicose vein surgery decreased from 5.8% to 1.2% (hematomas and groin infection). Patient and referring physician satisfaction was documented in 2004 and 2006 using questionnaires. Conclusions: The establishment of an academic venous surgical centre has proven useful in increasing clinical activity in terms of patient volume, providing more efficient and better continuity of care, ensuring less complications following varicose vein surgery, allowing the introduction of new treatment modalities, and resulting in overwhelming patient and treating physician satisfaction.
Use of New Treatment Modalities for Non-small Cell Lung Cancer Care in the Medicare Population