Trends in the quality of care for medicare beneficiaries admitted to the hospital with unstable angina. Commentary.
We sought to 1) determine the proportion of appropriate elderly patients admitted to the hospital with unstable angina who are treated with aspirin and heparin ; 2) identify patient factors associated with the Agency for Health Care Policy and Research (AHCPR) guideline-based use of aspirin and heparin ; and 3) compare practice patterns and patient outcomes before and after publication of the AHCPR guidelines.
Improving the care of patients with unstable angina may provide immediate opportunities to mitigate the adverse consequences of unstable angina.
However, despite the importance of this diagnosis, there is a paucity of information on the patterns of treatment and outcomes across diverse sites and recent trends in practice that have occurred, especially since the publication of the AHCPR practice guidelines.
We performed a retrospective cohort study using data created from medical charts and administrative files.
The sample included 300 consecutive patients admitted to one of three Connecticut hospitals in the period 1993 to 1994 and 150 consecutive patients admitted in 1995 with a principal discharge diagnosis of unstable angina or chest pain.
Of the 384 patients =65 years old who had no contraindications to aspirin on hospital admission, 276 (72%) received it.
Of the 369 patients =65 years old who had no contraindications to heparin on admission, 88 (24%) received it. (...)
Mots-clés Pascal : Angor instable, Soin, Qualité service, Hôpital, Acétylsalicylique acide, Héparine, Chimiothérapie, Traitement, Pratique professionnelle, Homme, Salicylés, Inhibiteur thromboagrégation, Glycosaminoglycane, Anticoagulant, Appareil circulatoire pathologie, Cardiopathie coronaire
Mots-clés Pascal anglais : Variant angina, Care, Service quality, Hospital, Acetylsalicylic acid, Heparin, Chemotherapy, Treatment, Professional practice, Human, Salicylates, Antiplatelet agent, Glycosaminoglycan, Anticoagulant, Cardiovascular disease, Coronary heart disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0244790
Code Inist : 002B02G. Création : 11/09/1998.