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Measuring of quality of care in patients with stroke and acute myocardial infarction: An application of algebra effectiveness model

Authors
 Kyoung Hee Cho  ;  Chung Mo Nam  ;  Sang Gyu Lee  ;  Tae Hyun Kim  ;  Seon-Heui Lee  ;  Eun-Cheol Park 
Citation
 MEDICINE, Vol.98(20) : e15353, 2019 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2019
MeSH
Acute Disease ; Adult ; Aged ; Aged, 80 and over ; Brain Ischemia/mortality* ; Emergency Service, Hospital ; Female ; Hospital Mortality/trends* ; Hospitalization ; Humans ; Intracranial Hemorrhages/mortality* ; Male ; Middle Aged ; Myocardial Infarction/epidemiology ; Myocardial Infarction/mortality* ; Patient Transfer ; Percutaneous Coronary Intervention/methods ; Quality of Health Care/statistics & numerical data* ; Quality of Health Care/trends ; Republic of Korea/epidemiology ; Stroke/epidemiology ; Stroke/mortality*
Abstract
Ischemic stroke, hemorrhagic stroke, and acute myocardial infarction (AMI) are diseases with golden hour. This study aimed to identify and compare factors that affect in-hospital mortality in patients with stroke and AMI who admitted via the emergency department.This study used the Korean National Health Insurance claims data from 2002 to 2013. The study sample included 7693 patients who had an ischemic stroke, 2828 patients who had a hemorrhagic stroke, and 4916 patients with AMI who were admitted via the emergency departments of a superior general hospital and general hospital, did not transfer to another hospital or come from another hospital, and were aged ≥20 years. This study was analyzed by using Cox's proportional hazards frailty model.Five hundred (6.5%) of 7693 patients with ischemic stroke, 569 (20.1%) of 2828 patients with hemorrhagic stroke, and 399 (8.1%) of 4916 patients with AMI were dead. The clinical factors were associated with in-hospital mortality such as age, CCI, hypertension, and diabetes of patient characteristics. In treatment characteristics, performing PCI and weekday admission was associated with in-hospital mortality (aHR, 0.43; 95% CI, 0.27-0.67; aHR, 1.42; 95% CI, 1.14-1.77, respectively). In hospital characteristics, the volume, the proportion of transferred patient to other hospital and ratio of beds per one nurse was associated with in-hospital mortality.Clinical factors of patient characteristics, intervention such as performing PCI and reducing ICP of treatment characteristics, and the volume, transferred rate, and the number of nurse of hospital characteristics were associated with in-hospital mortality.
Files in This Item:
T201901386.pdf Download
DOI
10.1097/MD.0000000000015353
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Hyun(김태현) ORCID logo https://orcid.org/0000-0003-1053-8958
Nam, Jung Mo(남정모) ORCID logo https://orcid.org/0000-0003-0985-0928
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
Lee, Sang Gyu(이상규) ORCID logo https://orcid.org/0000-0003-4847-2421
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169864
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