TY - JOUR T1 - Effectiveness of chest pain centre accreditation on the management of acute coronary syndrome: a retrospective study using a national database JF - BMJ Quality & Safety JO - BMJ Qual Saf SP - 867 LP - 875 DO - 10.1136/bmjqs-2020-011491 VL - 30 IS - 11 AU - Pengfei Sun AU - Jianping Li AU - Weiyi Fang AU - Xi Su AU - Bo Yu AU - Yan Wang AU - Chunjie Li AU - Hu Chen AU - Xingang Wang AU - Bin Zhang AU - Yuxi Li AU - Mohetaboer Momin AU - Ying Shi AU - Haibo Wang AU - Yan Zhang AU - Dingcheng Xiang AU - Yong Huo Y1 - 2021/11/01 UR - http://qualitysafety.bmj.com/content/30/11/867.abstract N2 - Background Large-scale real-world data to evaluate the impact of chest pain centre (CPC) accreditation on acute coronary syndrome (ACS) emergency care in heavy-burden developing countries like China are rare.Methods This study is a retrospective study based on data from the Hospital Quality Monitoring System (HQMS) database. This study included emergency patients admitted with ACS to hospitals that uploaded clinical data continuously to the database from 2013 to 2016. Propensity score matching was used to compare hospitals with and without CPC accreditation during this period. A longitudinal self-contrast comparison design with mixed-effects models was used to compare management of ACS before and after accreditation.Results A total of 798 008 patients with ACS from 746 hospitals were included in the analysis. After matching admission date, hospital levels and types and adjusting for possible covariates, patients with ACS admitted to accredited CPCs had lower in-hospital mortality (OR=0.70, 95% CI 0.53 to 0.93), shorter length of stay (LOS; adjusted multiplicative effect=0.89, 95% CI 0.84 to 0.94) and more percutaneous coronary intervention (PCI) procedures (OR=3.53, 95% CI 2.20 to 5.66) than patients admitted in hospitals without applying for CPC accreditation. Furthermore, when compared with the ‘before accreditation’ group only in accredited CPCs, the in-hospital mortality and LOS decreased and the usage of PCI were increased in both ‘accreditation’ (for in-hospital mortality: OR=0.86, 95% CI 0.79 to 0.93; for LOS: 0.94, 95% CI 0.93 to 0.95; for PCI: OR=1.22, 95% CI 1.18 to 1.26) and ‘after accreditation’ groups (for in-hospital mortality: OR=0.90, 95% CI 0.84 to 0.97; for LOS: 0.89, 95% CI 0.89 to 0.90; for PCI: OR=1.36, 95% CI 1.33 to 1.39). The significant benefits of decreased in-hospital mortality, reduced LOS and increased PCI usage were also observed for patients with acute myocardial infarction.Conclusions CPC accreditation is associated with better management and in-hospital clinical outcomes of patients with ACS. CPC establishment and accreditation should be promoted and implemented in countries with high levels of ACS.Data are available upon reasonable request. The data that support the findings of this study are available from China Standard Medical Information Research Center but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are however available from the authors upon reasonable request and with permission of China Standard Medical Information Research Center. ER -