The burden of acute myocardial infarction after a regional cardiovascular center project in Korea

Arim Kim, Seok-Jun Yoon, Young Ae Kim, Eun Jung Kim

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: The aim of this study was to examine the impact of a government-directed regional cardiovascular center (RCVC) project on the length of stay (LOS) and medical costs due to acute myocardial infarction (AMI). Design: A retrospective claim data review. Setting: Forty hospitals including four RCVCs in Korea. Participants: A total of 1469 AMI patients who visited a RCVC in two regions between February 2009 and December 2011. Intervention(s): RCVC project has been fostering specialized center by region for management of cardiovascular disease. It has built a system that could receive intensive care quickly within 3 h when disease occurred. Main Outcome Measure(s): Changes in the LOS and cost were evaluated using the difference-in-differences (DIDs) method combined with propensity score matching (1:1) and multilevel analysis with adjustment for patient's and institutional factors. Results: The net effect of RCVC project implementation showed decline of LOS (-0.71 days) and total medical costs (-797 US dollars) by DID. After the RCVC project, the LOS for patients with AMI hospitalized in a RCVC was decreased by 8.9% (β = -0.094, P = 0.041) compared with patients hospitalized in a hospital not designed as a RCVC. Compared with costs before the RCVC project, they were decreased by 11.5% (? = ?0.122, P = 0.004). Conclusions: We provided evidence regarding the change in the societal burden due to AMI after regionalization. Although there was a reduction of LOS and direct medical costs reported in limited number of regionalized hospitals, in the long term we can anticipate an expanding impact in all regionalized hospitals.

Original languageEnglish
Article numbermzv064
Pages (from-to)349-355
Number of pages7
JournalInternational Journal for Quality in Health Care
Volume27
Issue number5
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

Korea
Length of Stay
Myocardial Infarction
Costs and Cost Analysis
Insurance Claim Review
Multilevel Analysis
Propensity Score
Foster Home Care
Critical Care
Cardiovascular Diseases
Outcome Assessment (Health Care)

Keywords

  • Cardiovascular diseases
  • Care pathways/disease management
  • Evaluation methodology
  • Health policy
  • Health services research

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

The burden of acute myocardial infarction after a regional cardiovascular center project in Korea. / Kim, Arim; Yoon, Seok-Jun; Kim, Young Ae; Kim, Eun Jung.

In: International Journal for Quality in Health Care, Vol. 27, No. 5, mzv064, 01.01.2015, p. 349-355.

Research output: Contribution to journalArticle

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abstract = "Objective: The aim of this study was to examine the impact of a government-directed regional cardiovascular center (RCVC) project on the length of stay (LOS) and medical costs due to acute myocardial infarction (AMI). Design: A retrospective claim data review. Setting: Forty hospitals including four RCVCs in Korea. Participants: A total of 1469 AMI patients who visited a RCVC in two regions between February 2009 and December 2011. Intervention(s): RCVC project has been fostering specialized center by region for management of cardiovascular disease. It has built a system that could receive intensive care quickly within 3 h when disease occurred. Main Outcome Measure(s): Changes in the LOS and cost were evaluated using the difference-in-differences (DIDs) method combined with propensity score matching (1:1) and multilevel analysis with adjustment for patient's and institutional factors. Results: The net effect of RCVC project implementation showed decline of LOS (-0.71 days) and total medical costs (-797 US dollars) by DID. After the RCVC project, the LOS for patients with AMI hospitalized in a RCVC was decreased by 8.9{\%} (β = -0.094, P = 0.041) compared with patients hospitalized in a hospital not designed as a RCVC. Compared with costs before the RCVC project, they were decreased by 11.5{\%} (? = ?0.122, P = 0.004). Conclusions: We provided evidence regarding the change in the societal burden due to AMI after regionalization. Although there was a reduction of LOS and direct medical costs reported in limited number of regionalized hospitals, in the long term we can anticipate an expanding impact in all regionalized hospitals.",
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