Abstract

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, p = 0.001). The mortality rate of STEMI patients was not changed (β = −0.0098, p = 0.384) but that of NSTEMI patients decreased (β = −0.465, p = 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.

Highlights

  • Heart disease, including acute myocardial infarction, is the second most common cause of death in Korea [1]

  • We investigated the changes in the process and outcome indicators annually or monthly by hospital type and acute myocardial infarction (AMI) type (STEMI vs. NSTEMI) for years

  • Reperfusion treatment was administered to 93.9% segment elevation myocardial infarction (STEMI) and 75.1% of NSTEMI cases

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Summary

Introduction

Heart disease, including acute myocardial infarction, is the second most common cause of death in Korea [1]. The mortality rate associated with acute myocardial infarction (AMI) in Korea is 8.1%, which is higher than the average mortality rate of 7.5% in the OECD countries [2]. Patients should be treated as soon as possible after the onset of symptoms to reduce the risk of death. Guidelines for AMI diagnosis and treatment have been published by the American College of Cardiology (ACC) and the American Heart 4.0/).

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