ArticleBMC health services research2019
Level and variation on quality of care in China: a cross-sectional study for the acute myocardial infarction patients in tertiary hospitals in Beijing.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 17 citations in OpenAlex.
- Effects of familial hypercholesterolemia-associated genes on the phenotype of premature myocardial infarction.Lipids in health and disease · 2019Trial
- Variation in quality of care by medical institute level in China: a systematic review protocol.BMJ open · 2023Article
- Quality of Care in Public County Hospitals: A Cross-Sectional Study for Stroke, Pneumonia, and Heart Failure Care in Eastern China.International journal of environmental research and public health · 2022Article
- Bad to All? A Novel Way to Analyze the Effects of Fee-for-Service on Multiple Grades Hospitals Operation Outcomes.International journal of environmental research and public health · 2021Article
- Variations in length of stay of inpatients with COVID-19: A nationwide test of the new model of care under vision 2030 in Saudi Arabia.Saudi journal of biological sciences · 2021Article
- Pcsk9 is associated with severity of coronary artery lesions in male patients with premature myocardial infarction.Lipids in health and disease · 2021Article
- Article
- Perceived Competition and Process of Care in Rural China.Risk management and healthcare policy · 2020Article
- Reforming public hospital financing in China: progress and challenges.BMJ (Clinical research ed.) · 2019Article
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundQuality of care (QoC) attracts global concerns when unsafe and misuse of healthcare wastes resources and endangers people's health, especially in low- and middle-income countries. However, little is known about quality of care delivered in China. This study was intended to gauge the quality of care for acute myocardial infarction (AMI) patients in Beijing and identify the quality gaps across tertiary hospitals.
methodsOne thousand two hundred twenty eight patients, covered by Employee Essential Health Insurance Scheme and diagnosed of AMI, was sampled from 14 large comprehensive hospitals in Beijing, China. Chart review study was conducted through the discharge data and medical records of inpatients to evaluate 6 quality outcomes of interest, including the use of aspirin, beta blocker, and statin at discharge; use of aspirin within 24 h at arrival; angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blocker (ARB) for left ventricular systolic dysfunction (LVSD); percutaneous transluminal coronary intervention (PCI) within 90 min at arrival.
resultsOf the 1228 subjects, the mean age was 60.8 (11.8 SD) years and 83.0% were male. The overall medication prescribed was highly compliant with the clinical guidelines (97.0% [95% CI 96.8-97.2] for aspirin and 96.3% [95% CI 96.0-96.5] for statin), except for beta-blocker (83.6% [95% CI 83.0-84.1]) and ACEI/ARB use (61.4% [95% CI 60.7-62.2]). More than half of eligible patients did not receive appropriate PCI therapy (44.0% [95% CI 42.5-45.4]). Great variations across hospitals was observed in aspirin within 24 h and beta-blocker at discharge (P < 0.001), and the risk-adjusted results remained robust.
conclusionUnderuse of recommended treatment and significant variations of quality were found for AMI patients across tertiary hospitals in Beijing. It raised great concerns on poorer quality of care in other less-developed areas with less medical resources. Practical actions are needed in reducing quality gaps to ensure the delivery of quality care.
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