Dose Reducing Door-to-balloon Time in ST-elevation Myocardial Infarction Cause Less Cost?

This study has been completed.
Sponsor:
Information provided by (Responsible Party):
Chieh-Min Fan, Far Eastern Memorial Hospital
ClinicalTrials.gov Identifier:
NCT01545206
First received: March 1, 2012
Last updated: March 5, 2012
Last verified: March 2012
  Purpose

The investigators tried to determined whether the less D2B time led to costs savings benefited insurance payer and better outcomes to patients.


Condition
Acute STEMI
Primary Percutaneous Coronary Arterial Intervention

Study Type: Observational
Study Design: Observational Model: Cohort
Time Perspective: Retrospective
Official Title: Better Quality With Less Cost? A Single Hospital Experience on Reducing Door-to-balloon Time in ST-elevation Myocardial Infarction

Resource links provided by NLM:


Further study details as provided by Far Eastern Memorial Hospital:

Enrollment: 215
Study Start Date: February 1997
Study Completion Date: July 2010
Primary Completion Date: July 2010 (Final data collection date for primary outcome measure)
Groups/Cohorts
acute STEMI, Primpary PCI

Detailed Description:

The relationship between the quality of care and costs has been discussed widely. Higher costs of care did not bring better outcomes, vice versa. However, as the rising spending of health care, the health care providers, insurance payers, governments, and consumers begin to pursue the higher quality of cares with lowest costs. In surgical experiences, improving the process of care succeeded to improve the quality of care and reduce the costs.

In patients with acute ST-Segment elevation myocardial infarction (STEMI), A Door-to-Balloon (D2B) time of less than 90 minutes has been established as the gold standard for primary percutaneous coronary intervention (PCI) and was associated with lower in-hospital mortality.9 Only less literatures discussed the costs and the quality of care in acute STEMI, and whether improving processes of care associated with lower costs was still controversial. The Premier Hospital Quality Incentive Demonstration (PHQID) in United State improved the processes of care but had not a significant effect on cost. Another single hospital experience in Indiana, USA, showed that the reducing D2B time in STEMI decreased the insurance payments as well as the total hospital costs. However, this study design was before-and-after intervention analysis, did not actually measure the impact of D2B time. Besides, the payment system in this study was prospective payment, not fee-for-service payment in Taiwan.

In this study, we tried to determined whether the less D2B time led to costs savings benefited insurance payer and better outcomes to patients.

  Eligibility

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Patient presented between Feb. 1, 2007 and Jul. 31, 2009 at Far Eastern Memory Hospital for acute STEMI and unwent primary PCI.

Criteria

Inclusion Criteria:

  • self visit
  • acute STEMI by ECG definition

Exclusion Criteria:

  • non-diagnosis on first ECG
  • transferred
  • diagnostic angiogram only
  Contacts and Locations
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Please refer to this study by its ClinicalTrials.gov identifier: NCT01545206

Locations
Taiwan
Far Eastern Memorial Hospital
Taipei, Taiwan, 220
Sponsors and Collaborators
Far Eastern Memorial Hospital
Investigators
Principal Investigator: Chieh-Min Fan, MD, MSc Far Eastern Memorial Hospital
  More Information

No publications provided

Responsible Party: Chieh-Min Fan, Attending Physician, Far Eastern Memorial Hospital
ClinicalTrials.gov Identifier: NCT01545206     History of Changes
Other Study ID Numbers: 100046-E
Study First Received: March 1, 2012
Last Updated: March 5, 2012
Health Authority: Taiwan: Institutional Review Board

Additional relevant MeSH terms:
Infarction
Myocardial Infarction
Ischemia
Pathologic Processes
Necrosis
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases

ClinicalTrials.gov processed this record on September 18, 2014