| Summary: | 碩士 === 長庚大學 === 管理學院碩士學位學程在職專班醫務管理組 === 100 === The aim of this study is to investigate the association among emergency room treatments, patient’s prognosis, and medical consumptions of acute myocardial infarction patients. This study collected medical information of patients admitted to emergency department at a medical center in northern Taiwan between January 2008 and December 2010 and diagnosed as myocardial infraction upon discharge. A total of 1864 patients were collected. The variables include patient’s basic demographics, the physical indicators when entered emergency room, emergency room treatments, patient’s survival and medical consumptions. Cox regressions and generalized linear model were applied to analyze of patient’s prognosis and medical consumptions.
The findings demonstrated that: (1) The systolic blood pressure, pulse rate, ECG time, intubation or not, CPR or not and PCI affected patient’s survival. (2) The time of ECG and PCI intervention were the critical treatment items of acute myocardial infarctions patients. (3) The patient’s basic demographics affected the time of ECG, which affected patient’s survival. (4) Age and Charlson score were associated with total medical consumptions. (5) Primary PCI intervention reduced both ER and overall hospital stay mortality but increased medication consumptions.
This study suggests that hospital need to establish medical decision rules and quality indicators for emergency care of patients with acute myocardial infarction. Innovative management interventions are warranted to shorten time to ECG in future emergency care.
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