- 期刊
Effects of National Hospital Accreditation in Acute Coronary Syndrome on In-Hospital Mortality and Clinical Outcomes
摘要
Background: Acute coronary syndrome (ACS) is a life-threatening medical condition that accounts for an annual expenditure of more than $300 billion in the United States. Hospital accreditation has been shown to improve patient and hospital outcomes for various conditions. Objectives: This study aimed to determine the benefits of hospital accreditation in patients with ACS. Methods: This nationwide population-based cohort study used Taiwan's National Health Insurance Research Database from 1997 to 2011 (n = 249,354). Multivariable logistic regression was used to analyze the risk of in-hospital events among those treated in accredited and non-accredited hospitals, and to compare outcomes in hospitals before and after accreditation. The effect of accreditation on these events was also stratified by accreditation grade. Results: A total of 823 hospitals were included, of which 2.4% were medical centers, 13.7% were regional hospitals, and 83.8% were district hospitals. The in-hospital mortality [odds ratio (OR), 0.82; 95% confidence interval (CI), 0.79-0.85; p ＜ 0.001] and recurrent acute myocardial infarction (AMI) admission (OR, 0.81; 95% CI, 0.71-0.93; p = 0.003) rates were significantly lower in the after-accreditation group than in the before-accreditation group. There was a substantial and marked decrease in the in-hospital mortality rate after accreditation in 2008. Conclusions: This cohort study demonstrated that ACS accreditation was associated with better in-hospital mortality and recurrent AMI admission rates in ACS patients.
延伸閱讀
- 江蕙如（2017）。Association of Continuity of Care with Healthcare Outcomes and Expenses among Acute Myocardial Infarction Patients〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU201700096
- Tsai, H. W., Hsieh, S. R., Wei, H. J., Wang, C. C., Chang, Y., & Ho, H. C. (2004). Determinants of In-Hospital Mortality after Surgery for Acute Type A Aortic Dissection. Journal of the Formosan Medical Association, 103(6), 428-431. https://doi.org/10.29828/JFMA.200406.0006
- 范傑閔、鍾國彪、馬惠明、陳文鍾、朱樹勳（2006）。Development of Clinical Quality of Care Indicators for Acute Coronary Syndrome in Emergency Departments and a Current Performance Analysis at Two Northern Hospitals。中華民國急救加護醫學會雜誌，17(4)，146-157。https://doi.org/10.30018/JECCM.200612.0002
- Wang, H. K., Hu, S. C., Wang, T. D., Chen, W. J., & Huang, C. H. (2017). Prediction of Outcome of In-Hospital Mortality for Acute Heart Failure. Journal of Acute Medicine, 7(3), 107-114. https://doi.org/10.6705/j.jacme.2017.0703.003
- 范傑閔（2005）。Development of Clinical Quality of Care Indicators for Acute Coronary Syndrome in Emergency Department and Current Performance Analysis in Two Northern Hospitals〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU.2005.02466