European Observatory on Health Systems and Policies.
Jagiellonian University Medical College, Faculty of Health Science, Institute of Public Health.
Health Policy. 2021 May;125(5):587-592. doi: 10.1016/j.healthpol.2021.03.010. Epub 2021 Mar 25.
A new model of complex patient care after acute myocardial infarction (AMI) has been in operation in Poland since late 2017, comprising invasive treatment, cardiac rehabilitation and scheduled outpatient follow-up. Its stated objectives are to improve secondary prevention measures, quality of care and long-term health outcomes in AMI-patients. The model implements all key aspects of post-MI care recommended by the European Society of Cardiology (ESC), representing the first nation-wide model of structured and comprehensive post-MI care that closely follows ESC guidelines. The aim of this paper is to describe the background of this reform, its content and implementation as well as to assess its results. Early outcomes seem promising, with significantly lower mortality rate and lower risk of serious cardiological events in patients participating in the new model of care compared to patients who were not included. A comprehensive assessment of the reform will require further clinical data, covering a larger population and a longer period of time, as well as a holistic analysis of the programme in its wider context, taking into account potential benefits and cost-effectiveness of improved primary prevention implemented outside of this model.
自 2017 年末以来，波兰一直在实施一种新的急性心肌梗死（AMI）后复杂患者护理模式，包括侵入性治疗、心脏康复和定期门诊随访。其既定目标是改善 AMI 患者的二级预防措施、护理质量和长期健康结果。该模式实施了欧洲心脏病学会（ESC）推荐的所有关键的 MI 后护理方面，代表了第一个全国性的结构化和综合性 MI 后护理模式，紧密遵循 ESC 指南。本文旨在描述该改革的背景、内容和实施情况，并评估其结果。早期结果似乎很有希望，与未参与新模式护理的患者相比，参与新模式护理的患者死亡率显著降低，严重心脏事件的风险也降低。对改革的全面评估将需要进一步的临床数据，覆盖更大的人群和更长的时间，以及在更广泛的背景下对该计划进行全面分析，同时考虑到在该模式之外实施的改进初级预防的潜在效益和成本效益。
