Hospital length of stay for acute myocardial infarction patients in central rural area of China, 2001-2011
Zhang Danwei
Yang Jingwei
Wu Chaoqun
Huo Xiqian
Yu Yuan
Ge Yilan
Huang Xinghe
Zheng Xin
Li Jing
Jiang Lixin.
Abstract：This study described the hospital length of stay (LOS) for acute myocardial infraction (AMI) patients and its time trend between 2001 and 2011 in central rural area of China, explored the factors influencing the LOS. Method The study used a two-stage random sampling design to select patients admitted to 35 hospitals for AMI in 3 years (2001, 2006, and 2011) from central rural area of China. Patient information was obtained from medical records. Average LOS and its time trend in last decade were described. Hospitals were divided into 3 groups according to the median of LOS and patient characteristics, treatments and outcomes were compared across hospitals. Multivariate generalized linear model was used for testing the association between hospital level characteristics and LOS. Result 1475 AMI cases were included in the analysis. The mean LOS were respectively, (11.2±6.5) d in 2001, (10.6± 8.2) d in 2006, and (11.0±5.9) d in 2011, without significant difference or time trend. After adjusted for patients’ characteristics, there were no significant difference between years either. Patients characteristics were significantly different in history of hypertension, symptom onset to admission, chest pain, and pneumonia among high-, middle-and low-LOS hospitals. The detection rate of CK-MB was the lowest in middle-LOS hospitals (60.2%, P=0.010), and the use rate of heparin was the lowest in patients from low-LOS hospitals within 24 hours after admission (68.0%, P=0.003). There was no significant difference in diagnosis, treatment and outcomes among 3 hospital groups except for CK-MB diagnostic tests and heparin medication within 24 hours. Teaching hospitals and hospitals with relatively small AMI inpatient treatment volumes (＜30 annually) tended to have shorter LOS. Conclusion LOS in central rural area of China remained long compared with international standards and didn’t show a marked decline over the past decade. It’s critical to further shorten LOS to make the best use of limited medical resources for AMI patients.
Keywords：Acute myocardial infarctionLength of stayQuality of careHealth resources
Publication Date：2019-01-01
Pages：6( 32-37 )