• Heart attack mortality rate higher in th

    From ScienceDaily@1:317/3 to All on Thursday, May 05, 2022 22:30:40
    Heart attack mortality rate higher in the US compared to other high-
    income countries

    Date:
    May 5, 2022
    Source:
    University of Texas Medical Branch at Galveston
    Summary:
    When it comes to treating heart attacks, U.S. hospitals may have
    the latest tech and low readmission rates, but the country's
    mortality rate is one of the highest among the nations included
    in a new study. The study found substantial differences in care
    for heart attack patients across six high income countries despite
    international agreement on how heart attacks should be treated.



    FULL STORY ==========================================================================
    When it comes to treating heart attacks, U.S. hospitals may have the
    latest tech and low readmission rates, but the country's mortality rate
    is one of the highest among the nations included in a new study.


    ==========================================================================
    The study, published May 4 in The BMJ, found substantial differences in
    care for heart attack patients across six high income countries despite international agreement on how heart attacks should be treated.

    "No health care system seemed to be excelling in every aspect of heart
    attack care," said Dr. Peter Cram, professor and chair of internal
    medicine at the University of Texas Medical Center at Galveston, who is
    one of the authors of the study.

    Cram and collaborator Dr. Bruce Landon from Harvard developed the
    International Health System Research Collaborative to compare treatment
    and outcomes across high income countries. For this particular study, they examined data for patients 66 and older who were admitted to a hospital
    with a heart attack in six high income countries between 2011 and 2017.

    The countries they compared were the United States, Canada, England, Netherlands, Israel and Taiwan. Researchers chose these countries
    because they all have highly developed healthcare systems and accessible administrative data, but they differ in their financing, organization
    and overall performance in international rankings.

    Researchers chose to look at heart attacks, a common condition with
    established international diagnostic criteria and consensus about evidence-based treatments that is easy track with widely available data.



    ========================================================================== While the United States did well with cardiac revascularization --
    procedures to treat blockages in the coronary arteries -- and had low
    hospital readmission rates, the U.S. mortality rate along with Taiwan
    was higher than other countries and "concernedly high," Cram said.

    "The U.S. seems to focus really hard on those technologically advanced
    new and shiny things," he said. "Maybe, from a policy perspective, we
    should focus more on the mortality rate instead of getting people in
    and out of the hospital." By comparison, England and the Netherlands
    seemed to have lower mortality but far lower revascularization rates.

    "It seems to be about tradeoffs," Cram said. "Israel really seemed to
    be an exception, the only country that really seemed to perform well
    across all measures." The data is revealing.



    ==========================================================================
    "We previously didn't know this," Cram said. "We should be comparing
    ourselves to high-income countries as a mechanism for identifying where we
    are performing well and where we should focus our improvement efforts."
    What accounts for the higher mortality rate after one year for heart
    attack patients in the United States and Taiwan is not clear.

    "What is happening to our patients who have had heart attacks after they
    leave the hospital?" Cram said. "Is it gaps in wealth? Is it obesity
    rates? Is it people not taking recommended medications? We don't know."
    But the questions point to where more research is needed.

    "From a U.S. perspective, our heart attack care is good, but the one-year mortality rate is concerning," Cram said. "If dying is one of the things
    we want to prevent, then we have work to do."

    ========================================================================== Story Source: Materials provided by University_of_Texas_Medical_Branch_at_Galveston. Note: Content may be
    edited for style and length.


    ========================================================================== Journal Reference:
    1. Peter Cram, Laura A Hatfield, Pieter Bakx, Amitava Banerjee,
    Christina
    Fu, Michal Gordon, Renaud Heine, Nicole Huang, Dennis Ko, Lisa M
    Lix, Victor Novack, Laura Pasea, Feng Qiu, Therese A Stukel, Carin
    Uyl de Groot, Lin Yan, Bruce Landon. Variation in revascularisation
    use and outcomes of patients in hospital with acute myocardial
    infarction across six high income countries: cross sectional cohort
    study. BMJ, 2022; e069164 DOI: 10.1136/bmj-2021-069164 ==========================================================================

    Link to news story: https://www.sciencedaily.com/releases/2022/05/220505143829.htm

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