Integrated regional network construction for ST-segment elevation myocardial infarction care.
- Author:
Bin WANG
1
;
Yan WANG
2
;
Tao YE
;
Guosheng XIAO
;
He CHANG
;
Hongmei WEN
;
Yuan CHEN
;
Jiyi LIN
;
Lulin YANG
;
Jianhong YE
;
Lei HUANG
;
Lianfa CHEN
;
Yong CUI
;
Changqing FAN
;
Yueping WU
;
Qiaoke ZHENG
Author Information
- Publication Type:Journal Article
- MeSH: China; epidemiology; Community Networks; Cost Control; Electrocardiography; Hospital Mortality; Hospitalization; Humans; Length of Stay; Myocardial Infarction; mortality; therapy; Percutaneous Coronary Intervention; Time Factors
- From: Chinese Journal of Cardiology 2014;42(8):650-654
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the feasibility of establishing an integrated regional network for ST-segment elevation myocardial infarction (STEMI) care in China and evaluate the implementation effect of this network.
METHODSBased on real-time electrocardiogram transmission technology, we established an integrated regional network for STEMI care (IRN-STEMI) with Xiamen Heart Center as the core center, 120 Emergency Systems, PCI-capable hospitals and other community health units as core elements of this network. Reperfusion treatment data of Xiamen Heart Center including the number of patients receiving primary percutaneous coronary intervention (PCI), the mean first medical contact to balloon (FMC-to-B) time, the mean door to balloon (D-to-B) time, the mean length of hospital stay, the mean medical cost and in-hospital mortality were compared before (n = 165) and at 1 year after the built-up of IRN-STEMI (n = 343).
RESULTSCompared to pre-IRN-STEMI era, primary PCI ratio (84.5% (290/343) vs. 75.5% (185/245)) were significantly increased post establishment of IRN-STEMI within the network (P = 0.06). STEMI patients admitted in Xiamen Heart Center was significantly increased from 165 to 256, the annual mean FMC-to-B time ((110.3 ± 34.0)min vs. (137.9 ± 58.5) min, P < 0.01) and D-to-B ( (76.5 ± 33.0) min vs. (107.3 ± 38.0) min, P < 0.01) , as well as the mean medical cost were significantly decreased ( (51 398 ± 22 100) RMB vs. (56 970 ± 24 593) RMB, P < 0.05), while the mean length of hospital stay ((9.0 ± 4.3)d vs. (9.7 ± 4.8)d, P > 0.05) and in-hospital mortality (3.1% (8/256) vs. 3.0% (5/165) , P > 0.05) remained unchanged before and after the setting of IRN-STEMI in Xiamen Heart Center.
CONCLUSIONEstablishment of an integrated regional network system for STEMI patients in China is feasible. With collaboration of qualified heart center, EMS and PCI-capable and non-PCI capable local hospitals, establishment of IRN-STEMI effectively increased the ratio of primary PCI for STEMI patients, it also significantly shortened the FMC-to-B and D-to-B time, decreased mean medical cost, thus, the regional IRN-STEMI network might be an effective working system for improving the medical care for STEMI patients.
