Appropriate Use Criteria for Coronary Angiography at Two Hospitals in Southern Brazil: “Doing the Right Things And Doing Things Right”

Cardiovascular disease and particularly coronary artery disease (CAD) remain a global health issue, notwithstanding major advances in cardiovascular care that have resulted in a reduction in CAD mortality over the last decades. Indeed, the most recent trends point towards a bottoming out of CAD mortality rates and, for certain subgroups, rates might even be increasing. The reasons for these alarming trends relate to the prevalence of risk factors, health care system failures in dealing with chronic diseases, unequal access to technology, decreasing levels of investment in cardiovascular research, and persistent heterogeneity in the quality of care.

In contrast, cardiovascular health care costs continue to follow a linear upward trend. As a consequence, the delivery of high-value cardiovascular care has been reduced. In the long run, cardiovascular research and innovation should stimulate the development of novel drugs and therapies. In the short term, for struggling health care systems facing escalating costs, avoiding inappropriate tests and ineffective therapies is part of a value-based healthcare agenda.^, The fundamental concept of moving from volume to value may mitigate conflicting expectations among payers, providers, patients and physicians, who should share a common objective of reducing unwarranted health costs while improving outcomes.

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