Population Research Centre, JSS Institute of Economic Research, Dharwad, Karnataka, 580004, India.
Indian Heart J. 2021 Jul-Aug;73(4):424-428. doi: 10.1016/j.ihj.2021.05.001. Epub 2021 May 26.
Government of Goa initiated ST Elevation Myocardial Infarction(STEMI) - Goa project for achieving the objectives of Ayushman Bharat and Sustainable Development Goals to reduce the premature mortality from non-communicable diseases by one-third with adopting advanced health practices and modern technology. The project handles the escalating STEMI cases in Goa since December 2018.
Mix-method was used for data collection in this study and service statistics was collected from the hub and spoke hospitals. Additionally, staff engaged in the implementation of STEMI model were interviewed. We have visited 13 public health facilities including Goa Medical College where the 'Hub-and-Spoke' model of STEMI has institutionalized. The data was collected during October 2019 by employing the pre-designed checklist.
All patients who reached the hub-hospital undergone with angiography followed by angioplasty if required. Since the initiation of the project total of 546 patients were diagnosed with the STEMI and 85 percent of patients admitted with a STEMI were thrombolized, - subsequently, 64 percent of them undergone for angiography. Considering the mortality, around 6 percent of deaths have occurred during the past six months. Our study highlights the positive effect of the Hub-and-Spoke model on the treatment of patients with STEMI. The hub-and-spoke model is functioning effectively under the continuous monitoring of expert cardiologists. Additionally, the model has a review committee to investigate deceased cases, advanced cardiac care ambulances and modern ECGs technology.
The model can be implemented at a larger scale in other parts of India with the required human resource and advanced technology.
为了实现“印度保健全民覆盖”和可持续发展目标，减少三分之一的非传染性疾病导致的过早死亡率，果阿邦政府启动了 ST 段抬高型心肌梗死（STEMI）-果阿项目，以采用先进的医疗实践和现代技术。该项目自 2018 年 12 月以来一直在处理果阿不断增加的 STEMI 病例。
本研究采用混合方法收集数据，从枢纽和辐条医院收集服务统计数据。此外，还对参与实施 STEMI 模型的工作人员进行了访谈。我们访问了 13 家公共卫生机构，包括果阿医学院，该学院已经将 STEMI 的“枢纽和辐条”模式制度化。数据是在 2019 年 10 月通过使用预先设计的检查表收集的。
所有到达枢纽医院的患者都接受了血管造影检查，如果需要，还进行了血管成形术。自项目启动以来，共有 546 名患者被诊断为 STEMI，85%的 STEMI 患者入院时接受了溶栓治疗，随后 64%的患者接受了血管造影检查。考虑到死亡率，过去六个月内约有 6%的患者死亡。我们的研究强调了枢纽和辐条模型对 STEMI 患者治疗的积极影响。在专家心脏病学家的持续监测下，枢纽和辐条模型正在有效地运作。此外，该模型还设有一个审查委员会，负责调查死亡病例、先进的心脏护理救护车和现代心电图技术。
该模型可以在印度其他地区实施，需要相应的人力资源和先进技术。
