J Prev Med Public Health.  2019 Jan;52(1):21-29. 10.3961/jpmph.18.154.

Impact of Regional Cardiocerebrovascular Centers on Myocardial Infarction Patients in Korea: A Fixed-effects Model

• Cho SG
• Kim Y
• Choi Y
• Chung W

• KMID: 2440463
• DOI: http://doi.org/10.3961/jpmph.18.154

Abstract

OBJECTIVES
The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality.
METHODS
We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes.
RESULTS
We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of female in large catchment areas. There was no statistically significant impact on 30-day mortality.
CONCLUSIONS
The establishment of RCCVCs increased the number of treatment cases of female, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.

Keyword

Health impact assessment; Myocardial infarction; Delivery of health care; Program evaluation

MeSH Terms

Dataset
Delivery of Health Care
Emergencies
Female
Health Impact Assessment
Hospitals, Teaching
Humans
Insurance, Health
Korea*
Mortality
Myocardial Infarction*
Program Evaluation