TY - JOUR
T1 - Towards evidence-based management
T2 - A nationwide administrative data-based audit of acute myocardial infarction in Latvia
AU - Barzdins, Juris
AU - Luguzis, Artis
AU - Valeinis, Janis
AU - Lepiksone, Jana
AU - Skrule, Jolanta
AU - Pildava, Santa
AU - Konstante, Rita
N1 - Funding Information:
This study is part of the University of Latvia and the Centre for Disease Prevention and Control joint project ?Transparency and healthcare data?towards public monitoring for quality and efficiency?.
Publisher Copyright:
© 2019 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021/7/3
Y1 - 2021/7/3
N2 - 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.
AB - 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.
KW - administrative data
KW - Evidence-based management
KW - hospital process-orientation
KW - Latvia
KW - myocardial infarction
UR - http://www.scopus.com/inward/record.url?scp=85076440958&partnerID=8YFLogxK
U2 - 10.1080/20479700.2019.1693710
DO - 10.1080/20479700.2019.1693710
M3 - Article
AN - SCOPUS:85076440958
SN - 2047-9700
VL - 14
SP - 781
EP - 788
JO - International Journal of Healthcare Management
JF - International Journal of Healthcare Management
IS - 3
ER -
