Acute STEMI Clinical Trial
Official title:
Better Quality With Less Cost? A Single Hospital Experience on Reducing Door-to-balloon Time in ST-elevation Myocardial Infarction
The investigators tried to determined whether the less D2B time led to costs savings benefited insurance payer and better outcomes to patients.
The relationship between the quality of care and costs has been discussed widely. Higher
costs of care did not bring better outcomes, vice versa. However, as the rising spending of
health care, the health care providers, insurance payers, governments, and consumers begin
to pursue the higher quality of cares with lowest costs. In surgical experiences, improving
the process of care succeeded to improve the quality of care and reduce the costs.
In patients with acute ST-Segment elevation myocardial infarction (STEMI), A Door-to-Balloon
(D2B) time of less than 90 minutes has been established as the gold standard for primary
percutaneous coronary intervention (PCI) and was associated with lower in-hospital
mortality.9 Only less literatures discussed the costs and the quality of care in acute
STEMI, and whether improving processes of care associated with lower costs was still
controversial. The Premier Hospital Quality Incentive Demonstration (PHQID) in United State
improved the processes of care but had not a significant effect on cost. Another single
hospital experience in Indiana, USA, showed that the reducing D2B time in STEMI decreased
the insurance payments as well as the total hospital costs. However, this study design was
before-and-after intervention analysis, did not actually measure the impact of D2B time.
Besides, the payment system in this study was prospective payment, not fee-for-service
payment in Taiwan.
In this study, we tried to determined whether the less D2B time led to costs savings
benefited insurance payer and better outcomes to patients.
;
Observational Model: Cohort, Time Perspective: Retrospective
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Terminated |
NCT03743935 -
Use of Cardiac MRI in Early Stages of STEMI to Predict Left Ventricular Function Recovery and ICD Implantation
|
N/A |