National trends in hospital length of stay for acute myocardial infarction in China View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-12

AUTHORS

Qian Li, Zhenqiu Lin, Frederick A Masoudi, Jing Li, Xi Li, Sonia Hernández-Díaz, Sudhakar V Nuti, Lingling Li, Qing Wang, John A Spertus, Frank B Hu, Harlan M Krumholz, Lixin Jiang

ABSTRACT

BACKGROUND: China is experiencing increasing burden of acute myocardial infarction (AMI) in the face of limited medical resources. Hospital length of stay (LOS) is an important indicator of resource utilization. METHODS: We used data from the Retrospective AMI Study within the China Patient-centered Evaluative Assessment of Cardiac Events, a nationally representative sample of patients hospitalized for AMI during 2001, 2006, and 2011. Hospital-level variation in risk-standardized LOS (RS-LOS) for AMI, accounting for differences in case mix and year, was examined with two-level generalized linear mixed models. A generalized estimating equation model was used to evaluate hospital characteristics associated with LOS. Absolute differences in RS-LOS and 95% confidence intervals were reported. RESULTS: The weighted median and mean LOS were 13 and 14.6 days, respectively, in 2001 (n = 1,901), 11 and 12.6 days in 2006 (n = 3,553), and 11 and 11.9 days in 2011 (n = 7,252). There was substantial hospital level variation in RS-LOS across the 160 hospitals, ranging from 9.2 to 18.1 days. Hospitals in the Central regions had on average 1.6 days (p = 0.02) shorter RS-LOS than those in the Eastern regions. All other hospital characteristics relating to capacity for AMI treatment were not associated with LOS. CONCLUSIONS: Despite a marked decline over the past decade, the mean LOS for AMI in China in 2011 remained long compared with international standards. Inter-hospital variation is substantial even after adjusting for case mix. Further improvement of AMI care in Chinese hospitals is critical to further shorten LOS and reduce unnecessary hospital variation. More... »

PAGES

9

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1471-2261-15-9

DOI

http://dx.doi.org/10.1186/1471-2261-15-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1036725184

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25603877


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