Quality of care for myocardial infarction at academic and nonacademic hospitals

Autor: Didier Vilarem, Elodie Drouet, Michel Hanssen, Nicolas Danchin, José Labarère, Tabassome Simon, Jean Ferrières, Loic Belle, Jean-Jacques Dujardin, Magali Fourny, Geneviève Mulak, Philippe Bonnet
Přispěvatelé: BCM, Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble - UMR 5525 (TIMC-IMAG), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-CHU Grenoble, VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP )-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), IT University of Copenhagen, Service de cardiologie [Toulouse], Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Service de cardiologie [CHU Rouen], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-CHU Rouen, Normandie Université (NU)
Rok vydání: 2011
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Myocardial Infarction
Myocardial Reperfusion
030204 cardiovascular system & hematology
Cohort Studies
03 medical and health sciences
0302 clinical medicine
medicine
MESH: Myocardial Reperfusion
Survival advantage
Humans
030212 general & internal medicine
Myocardial infarction
MESH: Quality of Health Care
Quality of care
Prospective cohort study
Intensive care medicine
MESH: Cohort Studies
MESH: Teaching
MESH: Academic Medical Centers
Aged
Quality of Health Care
MESH: Aged
Academic Medical Centers
MESH: Humans
MESH: Middle Aged
business.industry
Teaching
Percutaneous coronary intervention
General Medicine
Process of care
Middle Aged
medicine.disease
MESH: Hospitals
Confidence interval
Frequent use
MESH: Male
Hospitals
3. Good health
MESH: France
MESH: Myocardial Infarction
Emergency medicine
[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie
Female
France
business
MESH: Female
Zdroj: The American Journal of Medicine
The American Journal of Medicine, Elsevier [Commercial Publisher] 2012, 125 (4), pp.365-73. ⟨10.1016/j.amjmed.2011.11.015⟩
ISSN: 1555-7162
0002-9343
DOI: 10.1016/j.amjmed.2011.11.015⟩
Popis: International audience; BACKGROUND: Whether academic hospitals provide better quality of care for patients with acute myocardial infarction is widely debated. The aim of this study was to compare processes of care and mortality between academic and nonacademic hospitals in the contemporary era of acute myocardial infarction management. METHODS: We analyzed the original data from a prospective cohort study of 3059 patients, including 1714 with ST-segment elevation and 1345 with non-ST-segment elevation myocardial infarction, enrolled at 39 and 183 academic and nonacademic hospitals, respectively, in France. RESULTS: Unadjusted 1-year mortality for academic and nonacademic hospitals was 10% versus 15% for patients with ST-segment elevation myocardial infarction (P=.01) and 13% versus 14% for patients with non-ST-segment elevation myocardial infarction (P=.75). Patients treated in academic or nonacademic hospitals with percutaneous coronary intervention capability were more likely to receive reperfusion and recommended drug therapies than those treated in nonacademic hospitals without percutaneous coronary intervention capability. After adjusting for baseline characteristics, the hazards of death associated with admission to nonacademic hospitals with and without percutaneous coronary intervention capability relative to academic hospitals were 1.13 (95% confidence interval [CI], 0.79-1.62) and 1.65 (95% CI, 1.09-2.49) for those with ST-segment elevation myocardial infarction and 0.95 (95% CI, 0.66-1.36) and 1.06 (95% CI, 0.72-1.58) for those with non-ST-segment elevation myocardial infarction, respectively. Further adjustment for receipt of acute reperfusion and recommended drug therapies eliminated all differences in mortality between the study groups. CONCLUSION: Admission to academic hospitals was associated with a more frequent use of recommended therapies, conveying a survival advantage for patients with ST-segment elevation myocardial infarction.
Databáze: OpenAIRE
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