Regional Differences in Process of Care and Outcomes for Older Acute Myocardial Infarction Patients in the United States and Ontario, Canada
| Autor: | David A. Alter, Alice Newman, Harlan M. Krumholz, Therese A. Stukel, Yongfei Wang, Jack V. Tu, Fredrick A. Masoudi, Dennis T. Ko, John J. You, JoAnne M. Foody, Edward P. Havranek |
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| Rok vydání: | 2007 |
| Předmět: |
Male
Canada medicine.medical_specialty Heart disease medicine.medical_treatment Myocardial Infarction law.invention Cohort Studies Randomized controlled trial law Physiology (medical) medicine Humans Myocardial infarction Intensive care medicine Aged Cardiac catheterization Aged 80 and over Ontario business.industry Mortality rate Process Assessment Health Care medicine.disease United States Hospitalization Treatment Outcome Heart catheterization Emergency medicine Female Cardiology and Cardiovascular Medicine business Regional differences Ontario canada |
| Zdroj: | Circulation. 115:196-203 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/circulationaha.106.657601 |
| Popis: | Background— Previous comparisons of acute myocardial infarction (AMI) treatment between the United States and Canada are limited because they compared selected patients from randomized trials, used administrative data that lacked clinical detail, or did not consider regional differences in AMI treatment. Methods and Results— We compared medication use, invasive cardiac procedure use, and 30-day risk-standardized mortality rates of 38 886 fee-for-service Medicare beneficiaries hospitalized with AMI in the United States and 5634 similarly aged patients in Ontario, Canada, from 1998 and 2001. Baseline characteristics and illness severity across the US regions and Ontario were not substantially different. Cardiac catheterization use in AMI patients was significantly higher in the United States compared with Ontario (38.7% versus 16.8%, P P P Conclusions— Previous studies have suggested a clear divergence in invasive cardiac therapy for AMI patients between the United States and Canada on the basis of health care financing and structural differences. Our findings of similar treatment patterns in the northeastern United States and Ontario suggest that regional practices may have a greater impact on treatment patterns than the respective health care delivery systems. |
| Databáze: | OpenAIRE |
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