Quality assurance with regard to outcome and use of medical resources for patients hospitalized with acute chest pain: a comparison between a city university hospital and a county hospital.

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Karlson, Björn W.,1953Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute (author)

Quality assurance with regard to outcome and use of medical resources for patients hospitalized with acute chest pain: a comparison between a city university hospital and a county hospital.

Article/chapterEnglish2003

Publisher, publication year, extent ...

Ovid Technologies (Wolters Kluwer Health),2003

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LIBRIS-ID:oai:gup.ub.gu.se/199581
https://gup.ub.gu.se/publication/199581URI
http://kipublications.ki.se/Default.aspx?queryparsed=id:132319443URI
https://doi.org/10.1097/00063110-200303000-00003DOI
https://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-7943URI

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Language:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

Notes

This study aimed to test the hypothesis that there is a difference in mortality between patients hospitalized with acute chest pain in a university hospital and those hospitalized in a county hospital, and to describe differences in characteristics and use of medical resources in these two settings. All patients hospitalized at Sahlgrenska University Hospital in Göteborg (with a catchment population of 706 inhabitants/km(2)) and Uddevalla County Hospital (with a catchment population of 34 inhabitants/km(2)) with symptoms of acute chest pain during a registration period of 6 months were included in the study. A total of 1592 patients in the city hospital and 822 in the county hospital fulfilled the given criteria for inclusion. Patients in the urban area differed from those in the rural area in that they had a lower prevalence of previous angina pectoris and hypertension and a higher prevalence of previous cancer, previous percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) and current smoking. On admission to hospital, patients in the urban area less frequently showed clinical signs of congestive heart failure and acute ischaemia on the electrocardiogram (ECG) but more frequently had a pathological ECG without signs of ischaemia and more frequently had a heart rate >100 beats/min. The use of medical resources differed between the two hospitals. Revascularization was more frequent in the city hospital and the use of -blockers in the county hospital. The overall 30 day mortality was 4.7% in the urban area and 4.3% in the rural area (P=0.74). When correcting for differences at baseline, the risk ratio for death in the county hospital versus the city hospital was 0.84 (95% confidence interval 0.51-1.40, P=0.53). In conclusion, among patients hospitalized with acute chest pain in a city university and a county hospital the mortality during the subsequent 30 days did not differ. However, there were differences in terms of the use of medical resources and in previous history, chronic medication prior to hospital admission and status on admission between the two cohorts.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine hsv//eng
Acute Disease
Aged
Chest Pain
mortality
Cohort Studies
Coronary Care Units
statistics & numerical data
Emergency Service
Hospital
standards
Female
Hospitalization
statistics & numerical data
Hospitals
County
standards
statistics & numerical data
Hospitals
University
standards
statistics & numerical data
Hospitals
Urban
standards
statistics & numerical data
Humans
Male
Outcome and Process Assessment (Health Care)
Quality Assurance
Health Care
statistics & numerical data
Retrospective Studies
Risk Factors
Sweden
epidemiology
Utilization Review

Added entries (persons, corporate bodies, meetings, titles ...)

Kalin, Björn (author)
Karlsson, Thomas,1956Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute(Swepub:gu)xkarth (author)
Svensson, LeifKarolinska Institutet (author)
Zehlertz, E (author)
Herlitz, Johan,1949Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute,[external](Swepub:hb)jhz (author)
Göteborgs universitetHjärt-kärlinstitutionen (creator_code:org_t)

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In:European journal of emergency medicine : official journal of the European Society for Emergency Medicine: Ovid Technologies (Wolters Kluwer Health)10:1, s. 6-120969-95461473-5695

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