National trends in hospital length of stay for acute myocardial infarction in China

BMC Cardiovascular Disorders

Research Article

Zhenqiu Lin¹  Harlan M Krumholz¹  Sudhakar V Nuti¹  Sonia Hernández-Díaz²  Frank B Hu³  Qian Li⁴  Lingling Li⁵  Frederick A Masoudi⁶  Qing Wang⁷  Lixin Jiang⁷  Xi Li⁷  Jing Li⁷  John A Spertus⁸ 

[1] Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA;Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA;Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA;Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA;Department of Nutrition, Harvard School of Public Health, Boston, MA, USA;Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA;Epidemiology, Worldwide Safety & Regulatory, Pfizer Inc., New York, NY, USA;Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA;Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA;National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, 100037, Beijing, China;Saint Luke’s Mid America Heart Institute, Kansas City, MO, USA;

关键词: Acute myocardial infarction;    Length of stay;    Variation in care;   

DOI  :  10.1186/1471-2261-15-9

 received in 2014-07-27, accepted in 2015-01-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundChina is experiencing increasing burden of acute myocardial infarction (AMI) in the face of limited medical resources. Hospital length of stay (LOS) is an important indicator of resource utilization.MethodsWe used data from the Retrospective AMI Study within the China Patient-centered Evaluative Assessment of Cardiac Events, a nationally representative sample of patients hospitalized for AMI during 2001, 2006, and 2011. Hospital-level variation in risk-standardized LOS (RS-LOS) for AMI, accounting for differences in case mix and year, was examined with two-level generalized linear mixed models. A generalized estimating equation model was used to evaluate hospital characteristics associated with LOS. Absolute differences in RS-LOS and 95% confidence intervals were reported.ResultsThe weighted median and mean LOS were 13 and 14.6 days, respectively, in 2001 (n = 1,901), 11 and 12.6 days in 2006 (n = 3,553), and 11 and 11.9 days in 2011 (n = 7,252). There was substantial hospital level variation in RS-LOS across the 160 hospitals, ranging from 9.2 to 18.1 days. Hospitals in the Central regions had on average 1.6 days (p = 0.02) shorter RS-LOS than those in the Eastern regions. All other hospital characteristics relating to capacity for AMI treatment were not associated with LOS.ConclusionsDespite a marked decline over the past decade, the mean LOS for AMI in China in 2011 remained long compared with international standards. Inter-hospital variation is substantial even after adjusting for case mix. Further improvement of AMI care in Chinese hospitals is critical to further shorten LOS and reduce unnecessary hospital variation.

【 授权许可】

Unknown   
© Li et al.; licensee BioMed Central. 2015. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.