Holiday Impact on Trends in Quality of Acute Coronary Syndrome Care

IF 2.1 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES

Journal of evaluation in clinical practice Pub Date : 2025-04-28 DOI:10.1111/jep.70109

Ruize Guo, Mengyang Liu, Lei Yu, Qianni Li, Shuang Hou, Meina Liu

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引用次数: 0

Abstract

Background

Acute coronary syndrome (ACS) is a common and serious cardiovascular disease with high morbidity and mortality. Timely diagnosis and treatment can help reduce the mortality of patients, but the arrival of the holidays may affect the quality of ACS treatment.

Objectives

To analyse the trends in the treatment quality of ACS care and the holiday season effect.

Methods

Joinpoint regression was performed to measure the overall trend in adherence rate of QIs from 1 January 2016, to 30 June 2020. The trends in emergency care quality over time was quantised by average monthly percentage change (AMPC). Interrupted time series were used to analyse the holiday season effect of the Spring Festival.

Results

The completion rates of five QIs (QI2, QI4, QI5, QI7, QI8) showed a continuous upward trend between 1 January 2016 and 30 June 2020, with QI4 showing the fastest upward trend between month 35 and month 38 (AMPC = 24.31%, p < 0.05). The completion rates of QI3, QI6 and QI9 showed an increasing trend at the beginning of the study and a decreasing trend at the later stages. Results of ITS model showed that there were immediate changes in rates of nine QIs before and after Chinese Spring Festival, with the largest decrease was in QI5 in phase 2 (level change = −13.94%, p < 0.05) and the highest increase was in QI4 in phase 4 (level change = 27.71%, p < 0.05). Excluding the effects of the holiday, completion rates continue to increase across the eight QIs.

Conclusions

Quality of care in ACS declined around the Spring Festival. Excluding the effect of holidays, the quality of ACS disease care showed an improving trend, especially in integrated care and multidisciplinary collaboration.

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假期对急性冠脉综合征护理质量趋势的影响

背景急性冠脉综合征（Acute coronary syndrome， ACS）是一种常见、严重的心血管疾病，发病率和死亡率都很高。及时的诊断和治疗有助于降低患者的死亡率，但假期的到来可能会影响ACS的治疗质量。目的分析ACS护理质量变化趋势及假日效应。方法采用关节点回归方法测量2016年1月1日至2020年6月30日QIs依从率的总体趋势。急诊护理质量随时间的变化趋势通过平均每月百分比变化（AMPC）量化。采用中断时间序列分析春节假期效应。结果2016年1月1日至2020年6月30日期间，QI2、QI4、QI5、QI7、QI8 5个指标的完成率呈持续上升趋势，其中QI4在第35 ~ 38个月期间上升最快（AMPC = 24.31%, p < 0.05）。QI3、QI6和QI9的完成率在研究开始时呈上升趋势，在研究后期呈下降趋势。ITS模型结果显示，春节前后9种QIs的发生率均有直接变化，其中第2期QI5下降幅度最大（水平变化= - 13.94%,p < 0.05），第4期QI4上升幅度最大（水平变化= 27.71%,p < 0.05）。排除假期的影响，八个qi的完成率继续上升。结论春节前后ACS患者的护理质量下降。排除假期的影响，ACS疾病护理质量呈提高趋势，尤其是综合护理和多学科协作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of evaluation in clinical practice 医学-卫生保健

CiteScore

4.80

自引率

4.20%

发文量

143

审稿时长

3-8 weeks

期刊介绍： The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.