Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model?
Source at https://doi.org/10.5301/heartint.5000238 . Introduction Acute myocardial infarction (AMI) is a potentially deadly disease and significant efforts have been concentrated on improving hospital performance. A 30-day survival rate has become a key quality of care indicator. In Northern Norway,...
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ftunivtroemsoe:oai:munin.uit.no:10037/13248 2023-05-15T17:39:24+02:00 Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model? Norum, Jan Hansen, Tonya Moen Hovland, Anders Balteskard, Lise Haug, Bjørn Olsen, Frank Trovik, Thor 2017-01-12 https://hdl.handle.net/10037/13248 https://doi.org/10.5301/heartint.5000238 eng eng SAGE Publications Heart International http://www.heart-int.com/article/77bc7c7e-753c-4cb2-90ba-03a5fe6c6cdf Norum, J., Hansen, T.M., Hovland, A., Balteskard, L., Haug, B., Olsen, F. & Trovik, T. (2017). Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model?. Heart International, 12(1), 24-30. https://doi.org/10.5301/heartint.5000238 FRIDAID 1566585 doi:10.5301/heartint.5000238 1826-1868 2036-2579 https://hdl.handle.net/10037/13248 openAccess VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771 VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771 Myocardial infarction Norway Quality Survival Journal article Tidsskriftartikkel Peer reviewed 2017 ftunivtroemsoe https://doi.org/10.5301/heartint.5000238 2021-06-25T17:55:50Z Source at https://doi.org/10.5301/heartint.5000238 . Introduction Acute myocardial infarction (AMI) is a potentially deadly disease and significant efforts have been concentrated on improving hospital performance. A 30-day survival rate has become a key quality of care indicator. In Northern Norway, some patients undergoing AMI are directly transferred to the Regional Cardiac Intervention Center at the University Hospital of North Norway in Tromsø. Here, coronary angiography and percutaneous coronary intervention is performed. Consequently, local hospitals may be bypassed in the treatment chain, generating differences in case mix, and making the treatment chain model difficult to interpret. We aimed to compare the treatment chain model with an alternative based on patients’ place of living. Methods Between 2013 and 2015, a total of 3,155 patients were registered in the Norwegian Patient Registry database. All patients were categorized according to their local hospital's catchment area. The method of Guo-Romano, with an indifference interval of 0.02, was used to test whether a hospital was an outlier or not. We adjusted for age, sex, comorbidity, and number of prior hospitalizations. Conclusions We revealed the 30-day AMI survival figure ranging between 88.0% and 93.5% (absolute difference 5.5%) using the hospital catchment method. The treatment chain rate ranged between 86.0% and 94.0% (absolute difference 8.0%). The latter figure is the one published as the National Quality of Care Measure in Norway. Local hospitals may get negative attention even though their catchment area is well served. We recommend the hospital catchment method as the first choice when measuring equality of care. Article in Journal/Newspaper North Norway Northern Norway Tromsø University of Tromsø: Munin Open Research Archive Norway Tromsø Heart International 12 1 heartint.500023 |
institution |
Open Polar |
collection |
University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
topic |
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771 VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771 Myocardial infarction Norway Quality Survival |
spellingShingle |
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771 VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771 Myocardial infarction Norway Quality Survival Norum, Jan Hansen, Tonya Moen Hovland, Anders Balteskard, Lise Haug, Bjørn Olsen, Frank Trovik, Thor Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model? |
topic_facet |
VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Kardiologi: 771 VDP::Medical disciplines: 700::Clinical medical disciplines: 750::Cardiology: 771 Myocardial infarction Norway Quality Survival |
description |
Source at https://doi.org/10.5301/heartint.5000238 . Introduction Acute myocardial infarction (AMI) is a potentially deadly disease and significant efforts have been concentrated on improving hospital performance. A 30-day survival rate has become a key quality of care indicator. In Northern Norway, some patients undergoing AMI are directly transferred to the Regional Cardiac Intervention Center at the University Hospital of North Norway in Tromsø. Here, coronary angiography and percutaneous coronary intervention is performed. Consequently, local hospitals may be bypassed in the treatment chain, generating differences in case mix, and making the treatment chain model difficult to interpret. We aimed to compare the treatment chain model with an alternative based on patients’ place of living. Methods Between 2013 and 2015, a total of 3,155 patients were registered in the Norwegian Patient Registry database. All patients were categorized according to their local hospital's catchment area. The method of Guo-Romano, with an indifference interval of 0.02, was used to test whether a hospital was an outlier or not. We adjusted for age, sex, comorbidity, and number of prior hospitalizations. Conclusions We revealed the 30-day AMI survival figure ranging between 88.0% and 93.5% (absolute difference 5.5%) using the hospital catchment method. The treatment chain rate ranged between 86.0% and 94.0% (absolute difference 8.0%). The latter figure is the one published as the National Quality of Care Measure in Norway. Local hospitals may get negative attention even though their catchment area is well served. We recommend the hospital catchment method as the first choice when measuring equality of care. |
format |
Article in Journal/Newspaper |
author |
Norum, Jan Hansen, Tonya Moen Hovland, Anders Balteskard, Lise Haug, Bjørn Olsen, Frank Trovik, Thor |
author_facet |
Norum, Jan Hansen, Tonya Moen Hovland, Anders Balteskard, Lise Haug, Bjørn Olsen, Frank Trovik, Thor |
author_sort |
Norum, Jan |
title |
Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model? |
title_short |
Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model? |
title_full |
Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model? |
title_fullStr |
Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model? |
title_full_unstemmed |
Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model? |
title_sort |
calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model? |
publisher |
SAGE Publications |
publishDate |
2017 |
url |
https://hdl.handle.net/10037/13248 https://doi.org/10.5301/heartint.5000238 |
geographic |
Norway Tromsø |
geographic_facet |
Norway Tromsø |
genre |
North Norway Northern Norway Tromsø |
genre_facet |
North Norway Northern Norway Tromsø |
op_relation |
Heart International http://www.heart-int.com/article/77bc7c7e-753c-4cb2-90ba-03a5fe6c6cdf Norum, J., Hansen, T.M., Hovland, A., Balteskard, L., Haug, B., Olsen, F. & Trovik, T. (2017). Calculating the 30-day survival in acute myocardial infarction: should we use the treatment chain or the hospital catchment model?. Heart International, 12(1), 24-30. https://doi.org/10.5301/heartint.5000238 FRIDAID 1566585 doi:10.5301/heartint.5000238 1826-1868 2036-2579 https://hdl.handle.net/10037/13248 |
op_rights |
openAccess |
op_doi |
https://doi.org/10.5301/heartint.5000238 |
container_title |
Heart International |
container_volume |
12 |
container_issue |
1 |
container_start_page |
heartint.500023 |
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1766140157148266496 |