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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

March 1, 2012
March 5, 2012
February 1997
July 2010   (final data collection date for primary outcome measure)
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Complete list of historical versions of study NCT01545206 on ClinicalTrials.gov Archive Site
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Dose Reducing Door-to-balloon Time in ST-elevation Myocardial Infarction Cause Less Cost?
Better Quality With Less Cost? A Single Hospital Experience on Reducing Door-to-balloon Time in ST-elevation Myocardial Infarction

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

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.

Observational
Observational Model: Cohort
Time Perspective: Retrospective
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Non-Probability Sample

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

  • Acute STEMI
  • Primary Percutaneous Coronary Arterial Intervention
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acute STEMI, Primpary PCI
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*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Completed
215
July 2010
July 2010   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • self visit
  • acute STEMI by ECG definition

Exclusion Criteria:

  • non-diagnosis on first ECG
  • transferred
  • diagnostic angiogram only
Both
18 Years and older
No
Contact information is only displayed when the study is recruiting subjects
Taiwan
 
NCT01545206
100046-E
Yes
Chieh-Min Fan, Far Eastern Memorial Hospital
Far Eastern Memorial Hospital
Not Provided
Principal Investigator: Chieh-Min Fan, MD, MSc Far Eastern Memorial Hospital
Far Eastern Memorial Hospital
March 2012

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP