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挪威亚北极地区急性心肌梗死的治疗。我们提供的护理质量均等吗?

Treatment of acute myocardial infarction in the sub-arctic region of Norway. Do we offer an equal quality of care?

作者信息

Norum J, Hovland A, Balteskard L, Trovik T, Haug B, Hansen F H, Alterskjær S, Madsen P, Olsen F

机构信息

a Department of Surgery , Finnmark Hospital , Hammerfest , Norway.

b Department of Clinical Medicine, Faculty of Health Science , UiT - The Arctic University of Norway , Tromsø , Norway.

出版信息

Int J Circumpolar Health. 2017;76(1):1391651. doi: 10.1080/22423982.2017.1391651.

Abstract

Patients, relatives, healthcare workers and administrators are concerned about the quality of care offered. We aimed to explore the treatment of acute myocatrdial infarction (AMI) in Northern Norway, compare it with the national figures, and document whether there is an equal quality of care or not. The retrospective study included data on patients' treatment for AMI. The following sources were employed. The Norwegian Patient Registry, National Quality of Care Database, Norwegian Myocardial Infarction Registry and data from the National Air Ambulance Services of Norway. The period 2012-2014/15 was studied and the variables were: incidence of AMI, gender and age adjusted rates of AMI and revascularization (PCI, CABG) based on patient's place of living (according to hospital catchment area) and 30-day survival rate. The annual incidence of AMI was 9% higher in the northern region. Significant incidence variations (2.7-5.9 AMI/1000 inhabitants) between the hospitals' catchment areas were revealed. The 30-day survival rate varied between 85.1-92.1% between hospitals. The variation in revascularization/AMI rate was 0.72-1.54. Air amublance services' availability varied through the day. In conclusion, significant variations in the AMI rate and an unequal service within the region was revealed.

摘要

患者、家属、医护人员及管理人员都十分关注所提供的医疗服务质量。我们旨在探究挪威北部急性心肌梗死(AMI)的治疗情况,将其与全国数据进行比较,并记录医疗服务质量是否均等。这项回顾性研究纳入了患者急性心肌梗死治疗的数据。采用了以下来源:挪威患者登记处、国家医疗质量数据库、挪威心肌梗死登记处以及挪威国家空中救护服务的数据。研究了2012 - 2014/15年期间,变量包括:急性心肌梗死发病率、基于患者居住地点(根据医院服务区域)的急性心肌梗死和血运重建(PCI、CABG)的性别及年龄调整率,以及30天生存率。北部地区急性心肌梗死的年发病率高出9%。各医院服务区域之间存在显著的发病率差异(2.7 - 5.9例急性心肌梗死/1000名居民)。各医院之间的30天生存率在85.1% - 92.1%之间。血运重建/急性心肌梗死率的差异为0.72 - 1.54。空中救护服务的可用性在一天中有所不同。总之,该地区急性心肌梗死率存在显著差异,且服务不均等。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b422/5678493/26ec372e236b/ZICH_A_1391651_F0001_C.jpg

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