Abstract 17470: Quality of Care for Patients Hospitalized With Acute Coronary Syndrome in China: Findings From the Improving Care for Cardiovascular Disease in China (CCC) Project - Acute Coronary Syndrome Program
Introduction: To explore effective strategies to improve the quality of care for acute coronary syndromes (ACS), AHA and Chinese Society of Cardiology have launched a collaborative program - Improving Care for Cardiovascular Disease in China (CCC Project). This study describes the performance of key quality measures during hospitalization and discharge for ACS in China.
Methods: CCC project established a nation-wide quality improvement registry among 150 tertiary hospitals in China. Clinical information of eleven key quality measures were collected continuously from November 2014 to March 2016 with standardized definitions and strict quality assurance for accuracy of the information. Average level and variation for performance of the 11 quality measures (five after arrival and six for discharge) and composite score based on these measures were evaluated.
Results: Among 35,616 ACS inpatients recruited, the performances for quality measure were low for ACEI/ARB at discharge (57.6%, range across hospitals: 11.3%-100%), β-blocker at discharge (66.6%, 12.3%-100%), evaluation for left ventricular systolic function (79.3%, 3.7%-100%) and smoking cessation advice (31.1%, 0%-100%) in patients with indications, with high variability across hospitals. High-performing measures included aspirin at arrival (95.4%, 76.3%-100%) and discharge (92.5%, 56.6%-100%), statins at discharge (92.2%, 46.3%-100%), clopidogrel at discharge (96.6%, 60.4%-100%) in eligible patients. In 22,962 STEMI patients, 53.3% (0%-100%) received acute reperfusion therapy, 28.7% (0%-100%) received fibrinolysis therapy within 30 min of hospital arrival among patients with fibrinolysis, and 59.1% (0%-100%) received primary PCI within 90 min of hospital arrival among patients who received primary PCI. The overall quality of care by composite score was 76.6% and varied widely among hospitals (49.9% to 90.3%).
Conclusions: There are substantial gaps between guideline recommendations and clinical practice for patients hospitalized with ACS in China even among tertiary hospitals. Continuous quality improvement strategies are warranted to narrow these gaps.
Author Disclosures: Y. Hao: None. J. Liu: None. J. Liu: None. S.C. Smith: None. Y. Huo: None. G.C. Fonarow: None. C. Ma: None. J. Ge: None. K.A. Taubert: None. L. Morgan: None. Y. Guo: None. Q. Zhang: None. W. Wang: None. D. Zhao: None.
- © 2016 by American Heart Association, Inc.