Indicators of quality of care for patients with acute myocardial infarction

Likelihood of coronary angiography among First Nations patients with acute myocardial infarction

“…Given that coronary angiography and revascularization are recommended for those with ST elevation MI (including those with failed thrombolytic therapy), [10][11][12] and for those with non-ST elevation MI in certain circumstances, [10][11][12][25][26][27] we conducted a sensitivity analysis among the subgroup with ST elevation MI who underwent coronary angiography.…”

“…Given that early invasive interventions improve outcomes in ST elevation MI, and in some cases in non-ST elevation MI, efforts to improve access to angiography for First Nations patients may improve their longterm outcomes. [10][11][12][25][26][27] Our results provide insight into the treatment and outcomes of coronary disease in this high-risk population.…”

“…We were unable to differentiate between ST elevation MI and non-ST elevation MI in our full study cohort (i.e., those identified as having acute MI based on International Classification of Diseases codes). Recognizing that treatment can differ for these 2 events, [10][11][12][25][26][27] particularly timing of cardiac catheterization, we evaluated likelihood of receipt of angiography at different time points (1 d, 30 d and 1 yr) in both our full cohort and in our subgroup of patients identified with ST elevation MI who underwent angiography (i.e., those identified as having ST elevation MI using APPROACH data).…”

“…8,9 As a result, it is unclear whether suboptimal delivery of guideline-recommended treatment contributes to increased cardiovascular morbidity and mortality among First Nations people. [10][11][12] We undertook a population-based study involving adults with incident acute myocardial infarction (MI) to examine the receipt of guideline-recommended coronary angiography among First Nations and non-First Nations patients. [10][11][12] Among patients who underwent angiography, we sought to determine whether there were differences between First Nations and non-First Nations patients in the likelihood of revascularization and long-term survival.…”

Quality of Care for First Nations and Non-First Nations People with Diabetes

“…Quality of care indicators are performance measures used to evaluate provision of recommended care (5), and are typically defined by clinical practice guidelines (6)(7)(8). Despite the potential importance of high-quality care (9), there is evidence that the quality of care is variable (10), with lack of adherence to quality of care standards contributing to worse clinical outcomes (11,12).…”