Résumé :
|
[BDSP. Notice produite par INIST 9kdKR0xr. Diffusion soumise à autorisation]. Context Issues of cost and quality are gaining importance in the delivery of medical care, and whether quality of care is better in teaching vs nonteaching hospitals is an essential question in this current national debate. Objective To examine the association of hospital teaching status with quality of care and mortality for fee-for-service Medicare patients with acute myocardial infarction (AMI). Design, Setting, and Patients Analysis of Cooperative Cardiovascular Project data for 114411 Medicare patients from 4361 hospitals (22354 patients from 439 major teaching hospitals, 22493 patients from 455 minor teaching hospitals, and 69564 patients from 3467 nonteaching hospitals) who had AMI between February 1994 and July 1995. Main Outcome Measures Administration of reperfusion therapy on admission, aspirin during hospitalization, and bêta-blockers and angiotensin-converting enzyme inhibitors at discharge for patients meeting strict inclusion criteria ; mortality at 30,60, and 90 days and 2 years after admission. Results Among major teaching, minor teaching, and nonteaching hospitals, respectively, administration rates for aspirin were 91.2%, 86.4%, and 81.4% (P<. for angiotensin-converting enzyme inhibitors and b reperfusion therapy>
|