[1]肖朝文简伟研.我国中部某地区急性ST段心肌梗死医疗质量研究[J].中国卫生质量管理,2019,26(05):26-29.[doi:10.13912/j.cnki.chqm.2019.26.5.09]

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我国中部某地区急性ST段心肌梗死医疗质量研究

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 第26卷期数: 2019年05期页码: 26-29 栏目: 医疗质量出版日期: 2019-09-28

作者:: 肖朝文简伟研; 北京大学公共卫生学院

关键词:: 医院; 中部地区; 急性ST段心肌梗死; 医疗质量

Keywords:: Hospital; Central Region; Acute ST-Segment Elevation Myocardial Infarction; Medical Quality

DOI:: 10.13912/j.cnki.chqm.2019.26.5.09

摘要:: 目的研究我国中部某地区急性ST段心肌梗死住院病例医疗质量，寻找原因，并针对性改进。方法从中国胸痛中心总部数据库获取2018年1月-6月我国中部某地区5家医院1 172例STEMI住院患者数据，以是否入院90 min内实施PCI、是否绕行CCU、是否进行双联抗血小板治疗、首次医疗接触时间至双联抗血小板治疗时间是否小于等于10min、是否入院24h内强化他汀治疗、是否出院后继续使用β阻滞剂、是否出院后继续使用他汀类药物、是否院内死亡8个变量为评价指标，建立线性概率模型控制年龄和性别后，分析不同医院间的医疗质量

Abstract:: ObjectiveTo investigate the medical quality of acute ST-segment elevation myocardial infarction (STEMI) in central region for reasons seeking and targeted improvements.MethodsThe 1,172 cases of inpatients with STEMI data in five hospitals in central China from January to June 2018 was obtained from the database of the Chest Pain Center Headquarters in China. The evaluation indexes included eight variables: whether to perform PCI within 90 minutes after admission, whether to CCU, whether to perform for dual antiplatelet therapy, time from first medical contact to dual antiplatelet less than or equal to 10 mins, strengthening statin treatment within 24 h of admission, whether continue to use the beta blockers after discharge, whether continue to use statins after discharge, occurrence of nosocomial death. A linear probability model was established to control age and gender, and then the differences of medical quality between different hospitals were analyzed.ResultsAfter controlling for age and gender, the implementation rates of the above eight indicators were all low in each hospital, among which the implementation rates of PCI and CCU within 90min after admission were as low as 22.58% and 20.69%, respectively. The hospitals with the best implementation of measures were 1.64 times, 1.79 times, 1.09 times, 1.14 times, 1.35 times, 1.21 times and 1.12 times respectively than the worst hospital, and the hospitals with the highest mortality rate was 1.04 times as much as those with the lowest.Conclusion The quality of STEMI medical treatment was low, the implementation of key medical measures was not in place, and the differences among hospitals were obvious. The government assessment should be further strengthened, hospital management should be emphasized, medical behavior should be standardized. Finally, medical quality should be improved continuously.

参考文献/References:

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更新日期/Last Update: 2019-09-28