Regional variation in the treatment and outcomes of myocardial infarction: Investigating New England's advantage
Regional variation in the treatment and outcomes of myocardial infarction: Investigating New England's advantage
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DOI：
10.1016/s0002-8703(03)00237-0
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发表时间：
2003-08-01
影响因子：
4.8
通讯作者：
Radford, MJ
中科院分区：
文献类型：
--
作者：
Krumholz, HM;Chen, J;Radford, MJ
背景先前的研究报道了新英格兰地区心肌梗死（MI）的治疗与美国其他地区不同。我们试图确定心肌梗死治疗的地区差异是否独立于患者、医院或医生特征的地区差异，以及新英格兰地区的实践模式是否与其他地区患者更好的结果相关。方法：对1994年至1996年间因心肌梗死住院的167,180例65岁患者进行评估，以评估护理质量的地区差异。评估患者入院时再灌注治疗、阿司匹林和β受体阻滞剂的使用情况和30天死亡率。分层逻辑回归模型用于确定新英格兰特有的实践模式是否独立于患者、医生、医院或其他地理特征的区域差异。结果新英格兰地区的-受体阻滞剂使用率最高（72%对52%）
Background Previous studies have reported that myocardial infarction (MI) treatment in New England differs from that of other regions of the United States. We sought to determine whether regional differences in MI treatment were independent of regional differences in patient, hospital, or physician characteristics, and whether the New England region's practice pattern was associated with better outcomes than those of patients in other regions.Methods We evaluated 167,180 patients aged : 65 years who were hospitalized with MI between 1994 to 1996 to assess regional variations in quality of care. Patients were evaluated for the use of reperfusion therapy, aspirin, and beta-blockers on admission and 30-day mortality rate. Hierarchical logistic regression models were used to determine whether practice patterns specific to New England were independent of regional variations in patient, physician, hospital, or other geographic characteristics.Results New England had the highest use of beta-blockers (72% vs 52% other regions, P