The burden of acute myocardial infarction after a regional cardiovascular center project in Korea
- Authors
- Kim, Arim; Yoon, Seok-Jun; Kim, Young-Ae; Kim, Eun Jung
- Issue Date
- 1-10월-2015
- Publisher
- OXFORD UNIV PRESS
- Keywords
- health policy; cardiovascular diseases; care pathways/disease management; evaluation methodology; health services research
- Citation
- INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE, v.27, no.5, pp.349 - 355
- Indexed
- SCIE
SSCI
SCOPUS
- Journal Title
- INTERNATIONAL JOURNAL FOR QUALITY IN HEALTH CARE
- Volume
- 27
- Number
- 5
- Start Page
- 349
- End Page
- 355
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/92226
- DOI
- 10.1093/intqhc/mzv064
- ISSN
- 1353-4505
- Abstract
- Objective: The aim of this study was to examine the impact of a government-directed regional cardiovascular center (RCVC) project on the length of stay (LOS) and medical costs due to acute myocardial infarction (AMI). Design: A retrospective claim data review. Setting: Forty hospitals including four RCVCs in Korea. Participants: A total of 1469 AMI patients who visited a RCVC in two regions between February 2009 and December 2011. Intervention(s): RCVC project has been fostering specialized center by region for management of cardiovascular disease. It has built a system that could receive intensive care quickly within 3 h when disease occurred. Main Outcome Measure(s): Changes in the LOS and cost were evaluated using the difference-indifferences (DIDs) method combined with propensity score matching (1: 1) and multilevel analysis with adjustment for patient's and institutional factors. Results: The net effect of RCVC project implementation showed decline of LOS (-0.71 days) and total medical costs (-797 US dollars) by DID. After the RCVC project, the LOS for patients with AMI hospitalized in a RCVC was decreased by 8.9% (beta = -0.094, P = 0.041) compared with patients hospitalized in a hospital not designed as a RCVC. Compared with costs before the RCVC project, they were decreased by 11.5% (beta = -0.122, P = 0.004). Conclusions: We provided evidence regarding the change in the societal burden due to AMI after regionalization. Although there was a reduction of LOS and direct medical costs reported in limited number of regionalized hospitals, in the long term we can anticipate an expanding impact in all regionalized hospitals.
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