scholarly journals Study of incidence and treatment of acute myocardial infarction by evaluating the financing database: 2004–2009

2012 ◽  
Vol 153 (3) ◽  
pp. 102-112 ◽  
Author(s):  
Éva Belicza ◽  
András Jánosi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Angioplasty ◽  
Hospital Care ◽  
Age Groups ◽  
Major Change ◽  
Healthcare Management ◽  
Insurance Fund ◽  
Number Of Patients ◽  
Observation Period

In Hungary we have no comprehensive data on hospital care and short and long term prognosis of patients with myocardial infarction. Aims: To collect data on number, hospital care and prognosis of patients treated for myocardial infarction in all Hungarian hospitals. Methods: Authors studied the number of patients treated in hospital for acute myocardial infarction, the frequency of revascularization by coronary angioplasty during treatment, as well as the 30 and 365 day mortality of patients by the evaluation of the financing database of the National Health Insurance Fund for 6 years (2004-2009). Results: There has been no major change during the observation period in the number of patients treated in hospital for myocardial infarction (approximately 16,500 cases/year). The incidence in males (calculated by the number of patients treated in hospital) is higher in any age group compared to females; this difference is lower in older age groups. During the observation period the 30 and 365 day mortality has decreased by 1.8% (18.9% vs. 17.1% and 29.9% vs. 28.1%, respectively), which was caused by a decrease in the mortality of patients above age 70. The percentage of revascularization by coronary angioplasty during the treatment of myocardial infarction has significantly increased (18.2% vs. 49.8%). The International Classification of Diseases does not differentiate between the different forms of myocardial infarction, therefore the prognostic effects of coronary angioplasty cannot be evaluated in this respect. Conclusions: Authors conclude that the financing database is suitable to evaluate the major aspects of care and to support healthcare management decisions, while the appropriateness of treatment and the effectiveness of different interventions can be assessed by prospective databases satisfying the needs of special aspects and can therefore be used for detailed assessments. Orv. Hetil., 2012, 153, 102–112.

scholarly journals Exploring the role of hospitals and office-based physicians in timely provision of statins following acute myocardial infarction: a secondary analysis of a nationwide cohort using cross-classified multilevel models

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e030272 ◽  
Author(s):  
Laura Schang ◽  
Daniela Koller ◽  
Sebastian Franke ◽  
L Sundmacher
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Discharge ◽  
Multilevel Models ◽  
Secondary Analysis ◽  
Credible Interval ◽  
Insurance Fund ◽  
Hospital Physician ◽  
Number Of Patients

ObjectivesTo examine the role of hospitals and office-based physicians in empirical networks that deliver care to the same population with regard to the timely provision of appropriate care after hospital discharge.DesignSecondary data analysis of a nationwide cohort using cross-classified multilevel models.SettingTransition from hospital to ambulatory care.ParticipantsAll patients discharged for acute myocardial infarction (AMI) from Germany’s largest statutory health insurance fund group in 2011.Main outcome measurePatients’ odds of receiving a statin prescription within 30 days after hospital discharge.ResultsWe found significant variation in 30-day statin prescribing between hospitals (median OR (MOR) 1.40; 95% credible interval (CrI) 1.36 to 1.45), hospital-physician pairs caring for the same patients (MOR 1.32; 95% CrI 1.26 to 1.38) and to a lesser extent between physicians (MOR 1.14; 95% CrI 1.11 to 1.19). About 67% of the variance between hospital-physician pairs and about 45% of the variance between hospitals was explained by hospital characteristics including a rural location, teaching status and the number of beds, the number of patients shared between a hospital and an office-based physician as well as 16 patient characteristics, including multimorbidity and dementia. We found no impact of physician characteristics.ConclusionsTimely prescription of appropriatesecondary prevention pharmacotherapy after AMI is subject to considerable practice variation which is not consistent with clinical guidelines. Hospitals contribute more to the observed variation than physicians, and most of the variation lies at the patient level. To ensure care continuity for patients, it is important to strengthen hospital capacity for discharge management and coordination between hospitals and office-based physicians.

scholarly journals A heveny szívinfarktus okozta országos epidemiológiai és egészségbiztosítási betegségteher Magyarországon

2021 ◽  
Vol 162 (Supplement-1) ◽  
pp. 6-13
Author(s):  
Noémi Németh ◽  
Dóra Endrei ◽  
Diána Elmer ◽  
Tímea Csákvári ◽  
Lilla Horváth ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Insurance ◽  
Inpatient Care ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Cost Driver ◽  
Insurance Fund ◽  
Insurance Costs ◽  
Classification Of Diseases

Összefoglaló. Bevezetés: A szív- és érrendszeri betegségek a vezető halálokok között szerepelnek világszerte, az összes halálozás egyharmadáért, míg az európai halálozások közel feléért felelősek. Célkitűzés: Vizsgálatunk célja volt a heveny szívinfarktus okozta epidemiológiai és egészségbiztosítási betegségteher elemzése. Adatok és módszerek: Adataink a Nemzeti Egészségbiztosítási Alapkezelő (NEAK) finanszírozási adatbázisából származnak a 2018-as évre vonatkozóan. Meghatároztuk az éves betegszámokat és a legnagyobb kiadással rendelkező ellátási forma, az aktívfekvőbeteg-szakellátás tekintetében a 100 000 főre jutó prevalenciát, valamint az éves egészségbiztosítási kiadásokat korcsoportos és nemenkénti bontásban az egyes ellátási típusokra vonatkozóan. A heveny szívinfarktust a Betegségek Nemzetközi Osztályozásának 10. revíziója alapján az I21-es kódcsoporttal azonosítottuk. Eredmények: A NEAK heveny szívinfarktusra fordított kiadása összesen 16,728 milliárd Ft (61,902 millió USD; 52,463 millió EUR) volt 2018-ban. A teljes kiadás 95,8%-át az aktívfekvőbeteg-szakellátás költségei (16,032 milliárd Ft; 59,321 millió USD; 50,276 millió EUR) képezték; ezen ellátási forma keretén belül összesen 16 361 fő (9742 férfi és 6619 nő) került kórházi felvételre. A valamennyi életkorra számított, 100 000 lakosra vetített prevalencia 208,54 beteg volt a férfiak és 129,61 beteg a nők esetében az aktívfekvőbeteg-szakellátásban. A nemenkénti eloszlást tekintve az aktívfekvőbeteg-szakellátásban a férfiak abszolút száma – a 75 év felettiek kivételével – valamennyi vizsgált korcsoportban meghaladta a nőkét. Következtetés: Az aktívfekvőbeteg-szakellátás igénybevétele bizonyult a legfőbb költségtényezőnek. Orv Hetil. 2021; 162(Suppl 1): 6–13. Summary. Introduction: Cardiovascular diseases have been the leading causes of death worldwide accounting for one third of all-cause mortality, and nearly half of mortality in Europe. Objective: The aim of our study was to determine the epidemiological disease burden of acute myocardial infarction. Data and methods: Data were derived from the financial database of the National Health Insurance Fund Administration (NHIFA) of Hungary for 2018. Data analysed included annual patient numbers, prevalence per 100 000 population in acute inpatient care, health insurance costs calculated for age groups and sex for all types of care. Patients with acute myocardial infarction were identified with the code: I21 of the International Classification of Diseases, 10th revision. Results: In 2018, NHIFA spent 16.728 billion HUF on the treatment of acute myocardial infarction, 61.902 million USD, 52.463 million EUR. Acute inpatient care accounted for 95.8% of costs (16.032 billion HUF; 59.321 million USD; 50.276 million EUR) with 16 361 persons (9742 male; 6619 females) hospitalised. Based on patient numbers in acute in-patient care, prevalence per 100 000 among men was 208.54, among women 129.61 patients. In all age groups, except for patients aged >75 years, the number of males was higher than that of females. Conclusion: Acute inpatient care was the major cost driver in the treatment of acute myocardial infarction. Orv Hetil. 2021; 162(Suppl 1): 6–13.

scholarly journals A kardiológiai rehabilitáció teljesítménymutatói Magyarországon

2019 ◽  
Vol 160 (Supplement 1) ◽  
pp. 6-12
Author(s):  
Imre Boncz ◽  
Andor Sebestyén ◽  
Tímea Csákvári ◽  
István Ágoston ◽  
Eszter Szabados ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Insurance ◽  
Cardiac Rehabilitation ◽  
Insurance Fund ◽  
Moderate Increase ◽  
Rehabilitation Care ◽  
Rehabilitation Hospital ◽  
Number Of Patients ◽  
Hospital Beds

Introduction: With the improvement of the survival of acute cardiac events and the increasing age, there is a higher demand for cardiac rehabilitation care. Aim: The aim of our study is to analyse the performance indicators of cardiac inpatient rehabilitation care in Hungary financed by the statutory public health insurance system. Data and methods: Data were derived from the financial database of the National Health Insurance Fund of Hungary. We analysed the period between 2014 and 2017. We investigated the distribution of cardiac rehabilitation hospital beds, the patient turnover and the rehabilitation rate following acute care. Results: In 2017, there were 1765 publicly financed cardiac rehabilitation hospital beds in Hungary (1.8 beds/10 000 population). We observed the lowest number of hospital bed number in Szabolcs-Szatmár-Bereg (0.27 beds/10 000 population), Hajdú-Bihar (0.28) and Fejér (0.6) counties. We found the highest number of hospital beds in Veszprém (11.47 beds/10 000 population), Győr-Moson-Sopron (4.94) counties and in Budapest (2.27). Between 2014 and 2017, the annual number of patients was between 24 834 and 26 146, while the number of nursing days varied between 510 thousand and 542 thousand. The average length of stay showed a moderate increase from 19.2 days/patient (2014) to 20.2 days/patient (2017). Only 6.6–7.6% of the patients who underwent acute myocardial infarction received cardiac rehabilitation care. Conclusion: We found significant regional inequalities in both the capacities and the access to and utilization of cardiac rehabilitation healthcare services, which should be mitigated by health policy activities. The low proportion (6.6–7.6%) of patients who underwent acute myocardial infarction and received cardiac rehabilitation care, should be increased. Orv Hetil. 2019; 160(Suppl 1): 6–12.

Primary care physician services and the frequency of comorbidities in patients with acute myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
R King ◽  
D Giedrimiene
Keyword(s):  
Myocardial Infarction ◽  
Primary Care ◽  
Acute Myocardial Infarction ◽  
Primary Care Physician ◽  
Care Physician ◽  
Adverse Outcomes ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Significant Difference ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background The management of patients with multiple comorbidities represents a significant burden on healthcare each year. Despite requiring regular medical care to treat chronic conditions, a large number of these patients may not receive proper care. Significant disparities have been identified in patients with multiple comorbidities and those who experience acute coronary syndrome or acute myocardial infarction (AMI). Only limited data exists to identify the impact of comorbidities and utilization of primary care physician (PCP) services on the development of adverse outcomes, such as AMI. Purpose The primary objective was to analyze how PCP services utilization can be associated with comorbidities in patients who experienced an AMI. Methods This study was based on retrospective data analysis which included 250 patients admitted to the Hartford Hospital Emergency Department (ED) for an AMI. Out of these, 27 patients were excluded due to missing documentation. Collected data included age, gender, medications and recorded comorbidities, such as hypertension, hyperlipidemia, diabetes mellitus (DM), chronic kidney disease (CKD) and previous arrhythmia. Each patient was assessed regarding utilization of PCP services. Statistical analysis was performed in order to identify differences between patients with documented PCP services and those without by using the Chi-square test. Results The records allowed for identification of documented PCP services for 172 out of 223 (77.1%) patients. The most common comorbidities were hypertension and hyperlipidemia: in 165 (74.0%) and 157 (70.4%) cases respectively. The most frequent comorbidity was hypertension: 137 out of 172 (79.7%) in pts with PCP vs 28 out of 51 (54.9%) without PCP, and significantly more often in patients with PCP, p< 0.001. Hyperlipidemia was the second most frequent comorbidity: in 130 out of 172 (75.6%) vs 27 out of 51 (52.9%) accordingly, and also significantly more often (p< 0.002) in patients with PCP services. The number of comorbidities ranged from 0-5, including 32 (14.3%) patients without comorbidities: 16 (9.3%) with a PCP and 16 (31.4%) without PCP services. The majority of patients - 108 (48.5% of 223), had 2-3 documented comorbidities: 89 (51.8%) had two and 19 (34.6%) had three. The remaining 40 (17.9%) patients had 4-5 comorbidities: 37 (21.5%) of them with a PCP and 3 (10.3%) without, with a significant difference (p < 0.001) found for patients with a higher number of comorbidities who utilized PCP services. Conclusions Our study shows that the majority of patients who presented with an AMI had one or more comorbidities. Furthermore, patients who did not utilize PCP services had fewer identified comorbidities. This suggests that there may be a significant number of patients who experienced AMI with undiagnosed comorbidities due to not having access to PCP services.

Sign in / Sign up

Export Citation Format

Share Document