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急性心肌梗死住院患者在认证医院和非认证医院之间主要临床结局的比较。

Comparison of Major Clinical Outcomes between Accredited and Nonaccredited Hospitals for Inpatient Care of Acute Myocardial Infarction.

机构信息

Health Insurance Review and Assessment Service, Wonju 26465, Korea.

Korea Institute for Healthcare Accreditation, Seoul 07238, Korea.

出版信息

Int J Environ Res Public Health. 2021 Mar 15;18(6):3019. doi: 10.3390/ijerph18063019.

Abstract

Hospital accreditation programs are used worldwide to improve the quality of care and improve patient safety. It is of great help in improving the structure of hospitals, but there are mixed research results on improving the clinical outcome of patients. The purpose of this study was to compare the levels of core clinical outcome indicators after receiving inpatient services from accredited and nonaccredited hospitals in patients with acute myocardial infarction (AMI). For all patients with AMI admitted to general hospitals in Korea from 2010 to 2017, their 30-day mortality and readmissions and length of stay were compared according to accreditation status. In addition, through a multivariate model that controls various patients' and hospitals' factors, the differences in those indicators were analyzed more accurately. The 30-day mortality of patients admitted to accredited hospitals was statistically significantly lower than that of patients admitted to nonaccredited hospitals. However, for 30-day readmission and length of stay, accreditation did not appear to yield more desirable results. This study shows that when evaluating the clinical impact of hospital accreditation programs, not only the mortality but also various clinical indicators need to be included, and a more comprehensive review is needed.

摘要

医院认证计划在全球范围内被用于提高医疗质量和保障患者安全。它在改善医院结构方面有很大的帮助,但对于改善患者的临床结局,其研究结果则存在差异。本研究旨在比较接受认证医院和非认证医院的急性心肌梗死(AMI)住院服务后,患者核心临床结局指标的水平。本研究对 2010 年至 2017 年期间韩国所有因 AMI 入住综合医院的患者,根据认证情况比较了他们的 30 天死亡率、再入院率和住院时间。此外,通过控制各种患者和医院因素的多变量模型,更准确地分析了这些指标的差异。与入住非认证医院的患者相比,入住认证医院的患者 30 天死亡率显著降低。然而,在 30 天再入院率和住院时间方面,认证似乎并没有产生更理想的结果。本研究表明,在评估医院认证计划的临床影响时,不仅需要考虑死亡率,还需要纳入各种临床指标,并进行更全面的审查。

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