Associations between Subsequent Hospitalizations and Primary Ambulatory Services Utilization within the First Year after Acute Myocardial Infarction and Long-Term Mortality

被引:0
作者
Plakht, Ygal [1 ,2 ]
Greenberg, Dan [3 ]
Gilutz, Harel [4 ]
Arbelle, Jonathan Eli [4 ,5 ]
Shiyovich, Arthur [6 ,7 ]
机构
[1] Ben Gurion Univ Negev, Fac Hlth Sci, Dept Nursing, IL-8410501 Beer Sheva, Israel
[2] Soroka Univ Med Ctr, Dept Emergency Med, IL-8410501 Beer Sheva, Israel
[3] Ben Gurion Univ Negev, Fac Hlth Sci, Sch Publ Hlth, Dept Hlth Syst Management, IL-8410501 Beer Sheva, Israel
[4] Ben Gurion Univ Negev, Fac Hlth Sci, Goldman Med Sch, IL-8410501 Beer Sheva, Israel
[5] Maccabi Healthcare Serv, Southern Dist, IL-8410501 Beer Sheva, Israel
[6] Rabin Med Ctr, Dept Cardiol, IL-49100 Petah Tiqwa, Israel
[7] Tel Aviv Univ, Sackler Fac Med, IL-6997801 Tel Aviv, Israel
关键词
acute myocardial infarction; healthcare resource utilization; mortality; prognosis; HEALTH-CARE COSTS; HEART-FAILURE; SECONDARY PREVENTION; MEDICATION ADHERENCE; 30-DAY READMISSIONS; AMERICAN-COLLEGE; TASK-FORCE; SURVIVORS; THERAPY; RISK;
D O I
10.3390/jcm9082528
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Healthcare resource utilization peaks throughout the first year following acute myocardial infarction (AMI). Data linking the former and outcomes are sparse. We evaluated the associations between subsequent length of in-hospital stay (SLOS) and primary ambulatory visits (PAV) within the first year after AMI and long-term mortality. This retrospective analysis included patients who were discharged following an AMI. Study groups: low (0-1 days), intermediate (2-7) and high (>= 8 days) SLOS; low (<10) and high (>= 10 visits) PAV, throughout the first post-AMI year. All-cause mortality was set as the primary outcome. Overall, 8112 patients were included: 55.2%, 23.4% and 21.4% in low, intermediate and high SLOS groups respectively; 26.0% and 74.0% in low and high-PAV groups. Throughout the follow-up period (up to 18 years), 49.6% patients died. Multivariable analysis showed that an increased SLOS (Hazard ratio (HR) = 1.313 and HR = 1.714 for intermediate and high vs. low groups respectively) and a reduced number of PAV (HR = 1.24 for low vs. high groups) were independently associated with an increased risk for mortality (p< 0.001 for each). Long-term mortality following AMI is associated with high hospital and low primary ambulatory services utilization throughout the first-year post-discharge. Measures focusing on patients with increased SLOS and reduced PAV should be considered to improve patient outcomes.
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页码:1 / 11
页数:12
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