Variations in the quality of care of patients with acute myocardial infarction among Swiss university hospitals.

Détails

Ressource 1Télécharger: serval:BIB_D3B1DA624317.P001 (96.36 [Ko])
Etat: Public
Version: de l'auteur
Licence: Non spécifiée
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
ID Serval
serval:BIB_D3B1DA624317
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Variations in the quality of care of patients with acute myocardial infarction among Swiss university hospitals.
Périodique
International Journal For Quality in Health Care
Auteur(s)
Luthi J.C., McClellan W.M., Flanders W.D., Pitts S.R., Burnand B.
ISSN
1353-4505 (Print)
ISSN-L
1353-4505
Statut éditorial
Publié
Date de publication
2005
Volume
17
Numéro
3
Pages
229-234
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
OBJECTIVE: The objective of our study was to assess hospital variations in the quality of care delivered to acute myocardial infarction (AMI) patients among three Swiss academic medical centres.
DESIGN: Cross-sectional study.
SETTING: Three Swiss university hospitals.
STUDY PARTICIPANTS: We selected 1129 eligible patients discharged from these hospitals from 1 January to 31 December 1999, with a primary or secondary diagnosis code [International Classification of Diseases, 10th revision (ICD-10)] of AMI. We abstracted medical records for information on demographic characteristics, risk factors, symptoms, and findings at admission. We also recorded the main ECG and laboratory findings, as well as hospital and discharge management and treatment. We excluded patients transferred to another hospital and who did not meet the clinical definition of AMI.
MAIN OUTCOME MEASURES: Percentage of patients receiving appropriate intervention as defined by six quality of care indicators derived from clinical practical guidelines.
RESULTS: Among 577 eligible patients with AMI in this study, the mean (SD) age was 68.2 (13.9), and 65% were male. In the assessment of the quality indicators we excluded patients who were not eligible for the procedure. Among cohorts of 'ideal candidates' for specific interventions, 64% in hospital A and 73% in hospital C had reperfusion within 12 hours either with thrombolytics or percutaneous transluminal coronary angioplasty (P = 0.367). Further, in hospitals A, B, and C, respectively 97, 94, and 84% were prescribed aspirin during the initial hospitalization (P = 0.0002), and respectively 68, 91, and 75% received angiotensin converting enzyme inhibitors at discharge in the case of left ventricular systolic dysfunction (P = 0.003).
CONCLUSIONS: Our results showed important hospital-to-hospital variations in the quality of care provided to patients with AMI between these three university hospitals.
Mots-clé
Acute Disease, Adolescent, Adrenergic beta-Antagonists/therapeutic use, Adult, Aged, Aged, 80 and over, Angioplasty, Balloon, Coronary/utilization, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Aspirin/therapeutic use, Cross-Sectional Studies, Female, Hospitals, Public/standards, Hospitals, University/organization & administration, Hospitals, University/standards, Hospitals, Urban/standards, Humans, Male, Middle Aged, Myocardial Infarction/diagnosis, Myocardial Infarction/therapy, Outcome and Process Assessment (Health Care)/methods, Quality Indicators, Health Care, Switzerland, Thrombolytic Therapy/utilization
Pubmed
Web of science
Open Access
Oui
Création de la notice
05/03/2008 9:30
Dernière modification de la notice
25/09/2019 6:10
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