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 language | English |
|---|---|
| Article number | mzv064 |
| Pages (from-to) | 349-355 |
| Number of pages | 7 |
| Journal | International Journal for Quality in Health Care |
| Volume | 27 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 2015 Jan 1 |
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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 journal › Article
}
TY - JOUR
T1 - The burden of acute myocardial infarction after a regional cardiovascular center project in Korea
AU - Kim, Arim
AU - Yoon, Seok-Jun
AU - Kim, Young Ae
AU - Kim, Eun Jung
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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.
KW - Cardiovascular diseases
KW - Care pathways/disease management
KW - Evaluation methodology
KW - Health policy
KW - Health services research
UR - http://www.scopus.com/inward/record.url?scp=84943790141&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84943790141&partnerID=8YFLogxK
U2 - 10.1093/intqhc/mzv064
DO - 10.1093/intqhc/mzv064
M3 - Article
VL - 27
SP - 349
EP - 355
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
SN - 1353-4505
IS - 5
M1 - mzv064
ER -