Validating Guidelines for Treatment of Patients with Acute Myocardial Infarction.Abstract, Executive Summary and Final Report

摘要

The authors data from the Cooperative Cardiovascular Project and studiedexperiences of patients in hospital and on discharge after an acute myocardial infarction. Patients were hospitalized in one of seven states (California Florida, Massachusetts, New York, Ohio, Pennsylvania, and Texas) between January 1, 1994 and July 31, 1995. These data were supplemented by information from the Veterans Administration, risk plans caring for Medicare enrollees, surveys from the American Hospital Association, surveys of hospital managers and physicians conducted by the authors, and surveys conducted by us with a sample of patients from this cohort. The authors' result shows that there is marked under-use of necessary angiography for patients who have suffered an AMI. This occurred in virtually all comparison groups examined, though it was highest (largest percentage of under-use) in patients in managed care settings and those with comorbid conditions, particularly chronic renal insufficiency. Treatment in a rural hospital or one that lacked angiography capability also predicted under-use.