Hub and spoke model to reduce mortality rate due to heart diseases

A recent report, based on a forthcoming study in the reputed international health journal, The Lancet, stated that the combination of poverty, ignorance, lack of access to quality care and smoking may be driving heart disease-related deaths in India. As this is the case in Tamil Nadu as well, the Health Department has initiated steps to check the deaths due to heart related diseases in the rural population. 

“The number of deaths due to heart related diseases has been increasing drastically in rural parts of the state, which has become a cause of worry,” said cardiologist Dr K Gopinath. Stating that immediate angiogram was the best treatment to ensure recovery in the case of a heart related diseases, Dr G Justin Paul, professor of cardiology, Madras Medical College, and state STEMI coordinator, said, “The challenge in this regard is the fact that cardiologists and cath labs are not there at every nook and corner in the state.”

To deal with the shortage, the state has started implementing the hub and spoke model as a pilot in a few hospitals. 

“Realising the challenges involved in having a cath lab in every corner of the state, we have started linking all the smaller cities as well. Recently, a cath lab was installed in Tirunelveli, which is the hub and we developed 10 spokes around it, which is together known as a cluster,” said Justin Paul, considered the brain behind the initiative. Explaining the functioning of the system, he said they have kept ambulances around these spokes, which would reach patients in remote villages, like in south Tamil Nadu, for instance, as soon as they receive a call. 

“The ambulance would reach the spot, pick up the patients and bring them to the spoke, where an ECG is taken. This will be checked at the same time by a cardiologist at the hub hospital. The doctor will advise those at the spoke hospital on what treatment needs to be administered. Following the primary treatment, the patient will be shifted to the hub,” explained the doctor. 

Stating that the initiative aims at reaching out to all rural areas as well, Darez Ahmed, director, National Health Mission, said, “Ensuring that all those who suffer from heart related diseases receive the same kind of treatment as soon as they make the call is the only way to check the burden of deaths. As of now, there are 12 clusters in the state.”