Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching Analysis
Reducing the treatment delay by organizing delivery of care on a regional basis is a priority for improving the quality of ST-segment elevated myocardial infarction (STEMI) care. This study aimed to evaluate the impact of the combined measures on quality metrics of healthcare delivery in Suzhou. The...
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doaj-8239df9c56d54c0d8a8cfa4a1ce23c672021-06-30T23:17:56ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012021-06-01186045604510.3390/ijerph18116045Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching AnalysisJunxiong Ma0Xuejie Dong1Yinzi Jin2Zhi-Jie Zheng3Department of Global Health, School of Public Health, Peking University, Beijing 100191, ChinaDepartment of Global Health, School of Public Health, Peking University, Beijing 100191, ChinaDepartment of Global Health, School of Public Health, Peking University, Beijing 100191, ChinaDepartment of Global Health, School of Public Health, Peking University, Beijing 100191, ChinaReducing the treatment delay by organizing delivery of care on a regional basis is a priority for improving the quality of ST-segment elevated myocardial infarction (STEMI) care. This study aimed to evaluate the impact of the combined measures on quality metrics of healthcare delivery in Suzhou. The data were collected from the National Chest Pain Center (CPC) Data Reporting Database. 4775 patients were recruited, and after propensity-score matching, 1078 pairs were finally included for analysis. We examined the changes in quality metrics of care including prehospital and in-hospital processes, and clinic outcomes. Quality improvement (QI) implementation improved most process indicators. However, these improvements did not yield decreased in-hospital mortality. The door-to-balloon and the FMC-to-device time decreased from 85.0 and 98.0 min to 78 and 88 min, respectively (<i>p</i> < 0.001). Cases transferred directly via EMS had a greater improvement in most of process indicators. The proportion of patients transferred directly via EMS was 10.3%, much lower than that of self-transported patients at 58.3%. Tertiary hospitals showed greater performance improvement in process indicators than secondary hospitals. The percentage of cases using EMS remained low for suburban areas. The establishment of coordinated STEMI care needs to be accompanied with solving the fragmented situation of the prehospital and hospital care, and patient delay should be addressed, especially in suburban areas and on transferred-in inpatients.https://www.mdpi.com/1660-4601/18/11/6045chest pain centerquality improvementSTEMI |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Junxiong Ma Xuejie Dong Yinzi Jin Zhi-Jie Zheng |
spellingShingle |
Junxiong Ma Xuejie Dong Yinzi Jin Zhi-Jie Zheng Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching Analysis International Journal of Environmental Research and Public Health chest pain center quality improvement STEMI |
author_facet |
Junxiong Ma Xuejie Dong Yinzi Jin Zhi-Jie Zheng |
author_sort |
Junxiong Ma |
title |
Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching Analysis |
title_short |
Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching Analysis |
title_full |
Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching Analysis |
title_fullStr |
Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching Analysis |
title_full_unstemmed |
Health Care Quality Improvement for ST-Segment Elevation Myocardial Infarction: A Retrospective Study Based on Propensity-Score Matching Analysis |
title_sort |
health care quality improvement for st-segment elevation myocardial infarction: a retrospective study based on propensity-score matching analysis |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2021-06-01 |
description |
Reducing the treatment delay by organizing delivery of care on a regional basis is a priority for improving the quality of ST-segment elevated myocardial infarction (STEMI) care. This study aimed to evaluate the impact of the combined measures on quality metrics of healthcare delivery in Suzhou. The data were collected from the National Chest Pain Center (CPC) Data Reporting Database. 4775 patients were recruited, and after propensity-score matching, 1078 pairs were finally included for analysis. We examined the changes in quality metrics of care including prehospital and in-hospital processes, and clinic outcomes. Quality improvement (QI) implementation improved most process indicators. However, these improvements did not yield decreased in-hospital mortality. The door-to-balloon and the FMC-to-device time decreased from 85.0 and 98.0 min to 78 and 88 min, respectively (<i>p</i> < 0.001). Cases transferred directly via EMS had a greater improvement in most of process indicators. The proportion of patients transferred directly via EMS was 10.3%, much lower than that of self-transported patients at 58.3%. Tertiary hospitals showed greater performance improvement in process indicators than secondary hospitals. The percentage of cases using EMS remained low for suburban areas. The establishment of coordinated STEMI care needs to be accompanied with solving the fragmented situation of the prehospital and hospital care, and patient delay should be addressed, especially in suburban areas and on transferred-in inpatients. |
topic |
chest pain center quality improvement STEMI |
url |
https://www.mdpi.com/1660-4601/18/11/6045 |
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