The association between in-hospital mortality, case management and chest pain centre accreditation status in accredited hospitals*
Endings or treatment procedures | Before accreditation | Undergoing accreditation | After accreditation | Undergoing or after accreditation | |||
ORa | 95% CI | ORa | 95% CI | ORa | 95% CI | ||
ACS | |||||||
In-hospital death | ref | 0.86 | (0.79 to 0.93) | 0.90 | (0.84 to 0.97) | 0.89 | (0.84 to 0.94) |
Length of stay | ref | 0.94 | (0.93 to 0.95) | 0.89 | (0.89 to 0.90) | 0.91 | (0.91 to 0.92) |
Total charge | ref | 1.00 | (0.99 to 1.01) | 0.98 | (0.97 to 0.99) | 0.99 | (0.98 to 0.99) |
PCI | ref | 1.22 | (1.18 to 1.26) | 1.36 | (1.33 to 1.39) | 1.31 | (1.28 to 1.34) |
AMI | |||||||
In-hospital death | ref | 0.84 | (0.77 to 0.93) | 0.90 | (0.83 to 0.97) | 0.88 | (0.82 to 0.94) |
Length of stay, day | ref | 0.94 | (0.93 to 0.95) | 0.88 | (0.87 to 0.89) | 0.91 | (0.90 to 0.91) |
Total charge | ref | 1.01 | (1.00 to 1.02) | 0.99 | (0.97 to 1.00) | 0.99 | (0.98 to 1.01) |
PCI | ref | 1.32 | (1.26 to 1.38) | 1.49 | (1.43 to 1.54) | 1.42 | (1.37 to 1.47) |
*Mixed-effect models were used in the analysis to control for hospital-associated random effects, a logistic regression model was used for the in-hospital death endpoint, a negative binomial model was used for the length-of stay endpoint and a generalised linear model with a log link and γ distribution was used for the charges endpoint. a:Results are presented as odds ratios for death, PCI and as multiplicativeeffect (eg, 2.0 = doubling) for length of stay and charges. Adjusted for sex, age, comorbidities (hypertension, diabetes, heart failure and old myocardial infarction), types and ranks of hospitals and geographical region (for total charge, percutaneous coronary intervention was also adjusted for).
ACS, acute coronary syndrome; AMI, acute myocardial infarction; PCI, percutaneous coronary intervention.