College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul 01757, Korea.
Int J Environ Res Public Health. 2022 Mar 8;19(6):3169. doi: 10.3390/ijerph19063169.
Public reporting is a way to promote quality of healthcare. However, evidence supporting improved quality of care using public reporting in patients with acute myocardial infarction (AMI) is disputed. This study aims to describe the impact of public reporting of AMI care on hospital quality improvement in Korea. Patients with AMI admitted to the emergency room with ICD-10 codes of I21.0 to I21.9 as the primary or secondary diagnosis were identified from the national health insurance claims data (2007-2012). Between 2007 and 2012, 43,240/83,378 (51.9%) patients manifested ST segment elevation myocardial infarction (STEMI). Timely reperfusion rate increased (β = 2.78, = 0.001). The mortality rate of STEMI patients was not changed (β = -0.0098, = 0.384) but that of NSTEMI patients decreased (β = -0.465, = 0.001). Public reporting has a substantial impact on the process indicators of AMI in Korea because of the increased reperfusion rate. However, the outcome indicators such as mortality did not significantly change, suggesting that public reporting did not necessarily improve the quality of care.
公开报告是提高医疗保健质量的一种方式。然而,在急性心肌梗死(AMI)患者中使用公开报告来提高护理质量的证据存在争议。本研究旨在描述在韩国,AMI 护理的公开报告对医院质量改进的影响。从国家健康保险索赔数据(2007-2012 年)中确定了因 ICD-10 编码 I21.0 至 I21.9 为主诊或次诊而被收入急诊室的 AMI 患者。在 2007 年至 2012 年间,43240/83378(51.9%)的患者表现出 ST 段抬高型心肌梗死(STEMI)。及时再灌注率增加(β=2.78, =0.001)。STEMI 患者的死亡率没有变化(β=-0.0098, =0.384),但 NSTEMI 患者的死亡率下降(β=-0.465, =0.001)。由于再灌注率的增加,公开报告对韩国 AMI 的过程指标产生了重大影响。然而,死亡率等结果指标没有显著变化,表明公开报告不一定能提高护理质量。