保守治疗在30天急性心肌梗死死亡率区域差异中的作用：捷克共和国一例

IF 1.1 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Central European journal of public health Pub Date : 2025-03-01 DOI:10.21101/cejph.a8462

Ivo Hlaváč, Matěj Opatrný

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引用次数: 0

摘要

目的：本研究的目的是分析保守治疗在捷克共和国急性心肌梗死（AMI）患者30天住院死亡率中的作用和地区差异。方法：使用捷克健康保险公司2018-2020年的行政数据，我们采用probit模型来检查13个复杂心血管中心的死亡率影响因素，计算平均边际效应以确保结果可解释。结果：与经皮冠状动脉介入治疗（PCI）相比，保守治疗与30天死亡率增加4.7个百分点相关（95% CI: 3.6-5.7）。这种影响在不同类型的急性心肌梗死和医疗保健提供者之间存在显著差异，相对于表现最好的中心，死亡率的区域差异从0到4.3个百分点不等。结论：在复杂的心血管中心，较高比例的保守治疗显著增加了30天死亡率。在控制患者特征后，持续的区域差异表明需要标准化的治疗方案和改进的数据收集系统，以减少结果的差异。

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The role of conservative treatment in regional variations of 30-day acute myocardial infarction mortality: a case of the Czech Republic.

Objectives: The aim of the study was to analyse the role of conservative treatment and regional differences in 30-day hospital mortality for acute myocardial infarction (AMI) patients in the Czech Republic.

Methods: Using administrative data from Czech health insurance companies for 2018-2020, we employed a probit model to examine factors influencing mortality across 13 complex cardiovascular centres, calculating average marginal effects to ensure interpretable results.

Results: Conservative treatment was associated with a 4.7 percentage point increase in 30-day mortality compared to percutaneous coronary intervention (PCI) treatment (95% CI: 3.6-5.7). This effect varied significantly across different types of AMI and healthcare providers, with regional variations in mortality ranging from 0 to 4.3 percentage points relative to the best-performing centre.

Conclusions: Higher proportions of conservative treatment significantly contribute to increased 30-day mortality in complex cardiovascular centres. The persistent regional variations after controlling for patient characteristics suggest the need for standardized treatment protocols and improved data collection systems to reduce disparities in outcomes.

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来源期刊

Central European journal of public health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

1.90

自引率

0.00%

发文量

期刊介绍： The Journal publishes original articles on disease prevention and health protection, environmental impacts on health, the role of nutrition in health promotion, results of population health studies and critiques of specific health issues including intervention measures such as vaccination and its effectiveness. The review articles are targeted at providing up-to-date information in the sphere of public health. The Journal is geographically targeted at the European region but will accept specialised articles from foreign sources that contribute to public health issues also applicable to the European cultural milieu.