Association of Physician and Hospital Volume With Use of Aspirin and Reperfusion Therapy in Acute Myocardial Infarction
| Autor: | R H Palmer, D J Willison, Stephen B. Soumerai |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Minnesota medicine.medical_treatment Myocardial Infarction Workload Drug Utilization Review Reperfusion therapy Fibrinolytic Agents Internal medicine Health care Medical Staff Hospital Humans Medicine Myocardial infarction Practice Patterns Physicians' Aged Retrospective Studies Cardiac catheterization Medical Audit Aspirin business.industry Public Health Environmental and Occupational Health Health services research Electrocardiography in myocardial infarction Retrospective cohort study Middle Aged medicine.disease Hospitals Logistic Models Outcome and Process Assessment Health Care Emergency medicine Cardiology Female Health Services Research business Total Quality Management medicine.drug |
| Zdroj: | Medical Care. 38:1092-1102 |
| ISSN: | 0025-7079 |
| Popis: | BACKGROUND The association between volume of patients treated and quality of care has important implications for patient referral policies and approaches to quality improvement. Most studies have focused on hospital volume alone and health outcomes. OBJECTIVES The objective of this work was to examine the association of hospital and physician volume with use of aspirin and reperfusion therapy in the management of acute myocardial infarction (AMI) in eligible patients. METHODS We reviewed charts of 2,215 patients treated at 35 Minnesota hospitals for AMI between October 1, 1992, and July 31, 1993, comparing use of aspirin and reperfusion therapy in eligible patients across different physician and hospital volume categories through multiple logistic regression. RESULTS Aspirin use did not vary significantly with physician volume. Use of reperfusion therapy was reduced among the lowest-volume physicians only (adjusted OR, 0.38; 95% CI, 0.15-0.94). Compared with the highest volume hospitals (treating >200 patients), aspirin use among lower-volume hospitals was lower. This was statistically significant only in the hospitals treating |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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