REVASCULARIZATION AFTER ACUTE MYOCARDIAL-INFARCTION - IMPACT OF HOSPITAL TEACHING STATUS AND ON-SITE INVASIVE FACILITIES

被引：15

作者：

COS, JL ^{[1
]}

CHEN, E ^{[1
]}

NAYLOR, CD ^{[1
]}

机构：

[1] SUNNYBROOK HLTH SCI CTR, INST CLIN EVALUAT SCI ONTARIO G-2, 2075 BAYVIEW AVE, N YORK, ON M4N 3M5, CANADA

来源：

JOURNAL OF GENERAL INTERNAL MEDICINE | 1994年 / 9卷 / 12期

关键词：

TEACHING HOSPITALS; MYOCARDIAL INFARCTION; REVASCULARIZATION; HOSPITAL SERVICES; UTILIZATION;

D O I：

10.1007/BF02599007

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

Objective: To investigate the influence of hospital teaching status and service availability on rates of revascularization following myocardial infarction. Design: Retrospective cohort study based on province-wide hospital discharge abstracts. Setting: All acute care hospitals in Ontario, Canada's most populous province (9.7 million). Patients: Patients admitted to hospital between April 1, 1991, and September 30, 1991, with a principal diagnosis of acute myocardial infarction. Measurements: The odds of a patient's having been referred for revascularization (angioplasty or bypass surgery) within six months of a myocardial infarction were calculated based on the type of hospital to which he or she had initially presented, defined as ''teaching'' or ''nonteaching'' or as having or not having interventional facilities onsite (cardiac catheterization and/or revascularization). Odds ratios were adjusted for potential confounding variables, and for possible joint effects of teaching status and on-site interventional capabilities. Results: The patients were more likely to have had revascularization (OR 1.79; 95% CI 1.47-2.14, p = 0.0001) when they had been admitted to a teaching hospital, and independently were more likely to have been referred for revascularization (OR 1.34; 95% CI 1.09-1.66, p = 0.0067) when they had been admitted to a hospital with on-site interventional facilities. There was no interaction between teaching status and service availability regarding referral for revascularization. Conclusion: Teaching status is an important determinant of revascularization following acute myocardial infarction and is independent of service availability, which also influences revascularization rates.

引用

页码：674 / 678

页数：5

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