Differences in cardiac procedures among patients in metropolitan and non-metropolitan hospitals in New South Wales after acute myocardial infarction and angina.
Differences in cardiac procedures among patients in metropolitan and non-metropolitan hospitals in New South Wales after acute myocardial infarction and angina.
复制标题
新南威尔士州大都市和非大都市医院急性心肌梗塞和心绞痛患者接受心脏手术的差异。
DOI：
10.1046/j.1440-1584.2000.00300.x
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发表时间：
2000
期刊：
影响因子：
--
通讯作者：
Peter J. Fletcher
中科院分区：
文献类型：
--
作者：
Richard F Heller;Rachel L. O'Connell;Catherine D'Este;L. Lim;Peter J. Fletcher
一项观察性队列研究检查了新南威尔士州（NSW）47家大城市或非大城市医院因急性胸痛住院期间和住院后心脏手术的使用差异。共有3836例患者，其中4151例在急性心肌梗死（AMI）、不稳定型心绞痛或其他心绞痛后入院。1695例患者完成了22个月随访。大都市医院的住院患者比非大都市医院的患者有更高的心脏手术率。比值比使用运动负荷试验、超声心动图、核研究和冠状动脉造影术的患者（95%置信区间）为3.30（1.38，7.90），9.34（4.07，21.44），4.87（2.08，11.39）和68.64（17.29，272.49），急性心肌梗死组（1.93（0.91，4.12）、5.60（1.60，19.57）、3.51（1.48，8.33）和38.57（9.36，158.94）。在出院后的22个月内，不同类型医院的发生率相似。大都市医院和非大都市医院之间资源使用的这种巨大差异是否适当需要检查。
An observational cohort study examined the difference in use of cardiac procedures during and after hospital admission for acute chest pain in 47 metropolitan or non-metropolitan hospitals across New South Wales (NSW). There were 3836 patients, represented by 4151 admissions to hospital after acute myocardial infarction (AMI), unstable angina or other angina. Follow up at 22 months was completed on 1695 patients. Patients admitted to metropolitan hospitals had higher rates of most cardiac procedures while in-patients than did patients in non-metropolitan hospitals. Odds ratios (95% confidence intervals) for the use of exercise stress tests, echocardiograms, nuclear studies and coronary angiography were 3.30 (1.38, 7.90), 9.34 (4.07, 21.44), 4.87 (2.08, 11.39) and 68.64 (17.29, 272.49), respectively, for patients with AMI and 1.93 (0.91, 4.12), 5.60 (1.60, 19.57), 3.51 (1.48, 8.33) and 38.57 (9.36, 158.94), respectively, for patients with unstable angina. Rates were similar between hospital types during the 22 months after discharge. The appropriateness of this large variation in resource use between metropolitan and non-metropolitan hospitals requires examination.