Hjerteinfarkt i Norge i 2013

Jortveit, Jarle; Govatsmark, Ragna Elise Støre; Digre, Tormod Aarlott; Risøe, Cecilie; Hole, Torstein; Mannsverk, Jan; Slørdahl, Stig A.; Halvorsen, Sigrun

doi:10.4045/tidsskr.14.0804

Cited by 30 publications

(21 citation statements)

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“…13 000 nordmenn innlagt med akutt hjerteinfarkt i norske sykehus (1). Flere studier har vist at kvinner kan ha mindre klare symptomer og kliniske funn, at de har lengre tidsforsinkelse til behandling, sjeldnere gjennomgår invasiv utredning og får faerre sekundaerprofylaktiske medikamenter ved utskrivning enn menn (2 -13).…”

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Kjønnsforskjeller i utredning og behandling av hjerteinfarkt

et al. 2016

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Kjønnsforskjeller i utredning og behandling av hjerteinfarkt

et al. 2016

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“…This could have lowered the clinical threshold for requesting supplementary cardiac markers in women, but the proportion of troponin-positive women compared to troponin-positive men does not support that this could be a major bias. The gender difference in prevalence found by Stähli et al [1] compares well with national registries of acute myocardial infarction with no upper age limit in which women account for about a third of the cases [3,4]. The male dominance is present both for ST-elevation myocardial infarctions and for non-ST-elevation myocardial infarctions [4].…”

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confidence: 49%

“…The gender difference in prevalence found by Stähli et al [1] compares well with national registries of acute myocardial infarction with no upper age limit in which women account for about a third of the cases [3,4]. The male dominance is present both for ST-elevation myocardial infarctions and for non-ST-elevation myocardial infarctions [4]. Further, European cause-of-death statistics show the same pattern for ischemic heart diseases in the total population [5] as well as for people over 65 years of age [6], with a surplus of male mortality, although the overrepresentation of men differs somewhat between countries.…”

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confidence: 81%

Suspected Acute Coronary Syndromes in Women

Risøe

2015

Cardiology

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“…Quality of care is now an integral part of modern medicine, exemplified most recently in Norway by the National Patient Safety Programme [1], a national strategy for quality improvement in health and social services [2], and several national registries [3, 4]. To define quality in health care, though, is challenging because of its subjective nature [5].…”

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confidence: 99%

The effect of referral templates on out-patient quality of care in a hospital setting: a cluster randomized controlled trial

Wåhlberg

Valle

Malm

et al. 2017

BMC Health Serv Res

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BackgroundThe assessment of quality of care is an integral part of modern medicine. The referral represents the handing over of care from the general practitioner to the specialist. This study aimed to assess whether an improved referral could lead to improved quality of care.MethodsA cluster randomized trial with the general practitioner surgery as the clustering unit was performed. Fourteen surgeries in the area surrounding the University Hospital of North Norway Harstad were randomized stratified by town versus countryside location. The intervention consisted of implementing referral templates for new referrals in four clinical areas: dyspepsia; suspected colorectal cancer; chest pain; and confirmed or suspected chronic obstructive pulmonary disease. The control group followed standard referral practice. Quality of treatment pathway as assessed by newly developed quality indicators was used as main outcome. Secondary outcomes included subjective quality assessment, positive predictive value of referral and adequacy of prioritization. Assessment of outcomes was done at the individual level. The patients, hospital doctors and outcome assessors were blinded to the intervention status.ResultsA total of 500 patients were included, with 281 in the intervention and 219 in the control arm. From the multilevel regression model the effect of the intervention on the quality indicator score was insignificant at 1.80% (95% CI, −1.46 to 5.06, p = 0.280). No significant differences between the intervention and the control groups were seen in the secondary outcomes. Active use of the referral intervention was low, estimated at approximately 50%. There was also wide variation in outcome scoring between the different assessors.ConclusionsIn this study no measurable effect on quality of care or prioritization was revealed after implementation of referral templates at the general practitioner/hospital interface. The results were hindered by a limited uptake of the intervention at GP surgeries and inconsistencies in outcome assessment.Trial registrationThe study was registered under registration number NCT01470963 on September 5th, 2011.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2127-1) contains supplementary material, which is available to authorized users.

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Hjerteinfarkt i Norge i 2013

Abstract: This first report from the Norwegian Myocardial Infarction Registry shows that the treatment service is functioning well for most patients. Secondary prophylaxis using drug therapy and increased use of invasive examination of patients with nSTEMI appear to be areas for improvement.

Cited by 30 publications

References 5 publications

Kjønnsforskjeller i utredning og behandling av hjerteinfarkt

Kjønnsforskjeller i utredning og behandling av hjerteinfarkt

Suspected Acute Coronary Syndromes in Women

The effect of referral templates on out-patient quality of care in a hospital setting: a cluster randomized controlled trial

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