Towards evidence-based management: A nationwide administrative data-based audit of acute myocardial infarction in Latvia

Juris Barzdins (Coresponding Author), Artis Luguzis, Janis Valeinis, Jana Lepiksone, Jolanta Skrule, Santa Pildava, Rita Konstante

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


When care for an individual patient is determined by evidence-based medical guidelines, the management of the whole clinical process also needs to be based on evidence. In Latvia, an careful retrospective data analysis is needed to suggest evidence-based organizational interventions for the care of acute myocardial infarction (AMI), since a 30-day AMI mortality here remains one of the highest among the OECD Member States. An audit based on Healthcare reimbursement data linked to the causes of death registry from 2014-2018 was performed. Analysed 11 065 ST-elevation AMI cases reveals lower mortality for patients directly admitted to hospitals able to perform percutaneous coronary intervention (preferred reperfusion option according to guidelines) compared to patients initially admitted to a large group of local hospitals (able to perform only thrombolysis-based reperfusion). However, no statistically significant type-of-hospital effect for this group of hospitals is found, when other factors - including treatment type - are accounted for in logistic regression analysis of factors influencing AMI-mortality. That combined with vastly improved survival opportunities if any reperfusion procedure is used suggests that decreasing the proportion of non-reperfusion patients by applying any reperfusion procedure might be one of the main directions for the improvement of AMI outcomes in Latvia.

Original languageEnglish
Pages (from-to)781-788
Number of pages8
JournalInternational Journal of Healthcare Management
Issue number3
Publication statusPublished - 3 Jul 2021
Externally publishedYes


  • administrative data
  • Evidence-based management
  • hospital process-orientation
  • Latvia
  • myocardial infarction

Field of Science*

  • 3.3 Health sciences

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database


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