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Jankowski P, Topór-Mądry R, Gąsior M, Cegłowska U, Eysymontt Z, Gierlotka M, Wita K, Legutko J, Dudek D, Sierpiński R, Pinkas J, Kaźmierczak J, Witkowski A, Szumowski Ł. Innovative Managed Care May Be Related to Improved Prognosis for Acute Myocardial Infarction Survivors. Circ Cardiovasc Qual Outcomes 2021; 14:e007800. [PMID: 34380330 DOI: 10.1161/circoutcomes.120.007800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mortality following discharge in myocardial infarction survivors remains high. Therefore, we compared outcomes in myocardial infarction survivors participating and not participating in a novel, nationwide managed care program for myocardial infarction survivors in Poland. METHODS We used public databases. We included all patients hospitalized due to acute myocardial infarction in Poland between October 1, 2017 and December 31, 2018. We excluded from the analysis all patients aged <18 years as well as those who died during hospitalization or within 10 days following discharge from hospital. All patients were prospectively followed. The primary end point was defined as death from any cause. RESULTS The mean follow-up was 324.8±140.5 days (78 034.1 patient-years; 340.0±131.7 days in those who did not die during the observation). Participation in the managed care program was related to higher odds ratio of participating in cardiac rehabilitation (4.67 [95% CI, 4.44-4.88]), consultation with a cardiologist (7.32 [6.83-7.84]), implantable cardioverter-defibrillator (1.40 [1.22-1.61]), and cardiac resynchronization therapy with cardioverter-defibrillator implantation (1.57 [1.22-2.03]) but lower odds of emergency (0.88 [0.79-0.98]) and nonemergency percutaneous coronary intervention (0.88 [0.83-0.93]) and coronary artery bypass grafting (0.82 [0.71-0.94]) during the follow-up. One-year all-cause mortality was 4.4% among the program participants and 6.0% in matched nonparticipants. The end point consisting of all-cause death, myocardial infarction, or stroke occurred in 10.6% and 12.0% (P<0.01) of participants and nonparticipants respectively, whereas all-cause death or hospitalization for cardiovascular reasons in 42.2% and 47.9% (P<0.001) among participants and nonparticipants, respectively. The difference in outcomes between patients participating and not participating in the managed care program could be explained by improved access to cardiac rehabilitation, cardiac care, and cardiac procedures. CONCLUSIONS Managed care following myocardial infarction may be related to improved prognosis as it may facilitate access to cardiac rehabilitation and may provide a higher standard of outpatient cardiac care.
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Affiliation(s)
- Piotr Jankowski
- I Department of Cardiology, Interventional Electrocardiology and Hypertension, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland (P.J.)
| | - Roman Topór-Mądry
- Agency for Health Technology Assessment and Tariff System, Warsaw, Poland (R.T.-M., U.C.)
| | - Mariusz Gąsior
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze (M. Gąsior), Medical University of Silesia, Katowice, Poland
| | - Urszula Cegłowska
- Agency for Health Technology Assessment and Tariff System, Warsaw, Poland (R.T.-M., U.C.)
| | - Zbigniew Eysymontt
- Cardiac Rehabilitation Department, Ślaskie Centrum Rehabilitacji w Ustroniu, Ustron, Poland (Z.E.)
| | - Marek Gierlotka
- Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Poland (M. Gierlotka)
| | - Krystian Wita
- First Department of Cardiology, School of Medicine in Katowice (K.W.), Medical University of Silesia, Katowice, Poland
| | - Jacek Legutko
- Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland (J.L.)
| | - Dariusz Dudek
- Institute of Cardiology, Jagiellonian University, Kopernika 17, Krakow, Poland (D.D.)
| | | | - Jarosław Pinkas
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland (J.P.)
| | - Jarosław Kaźmierczak
- Department of Cardiology, Pomeranian Medical University, Szczecin, Poland (J.K.)
| | - Adam Witkowski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland (A.W.)
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Thomas EE, Haydon HM, Mehrotra A, Caffery LJ, Snoswell CL, Banbury A, Smith AC. Building on the momentum: Sustaining telehealth beyond COVID-19. J Telemed Telecare 2020; 28:301-308. [DOI: 10.1177/1357633x20960638] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current coronavirus pandemic (COVID-19) has resulted in tremendous growth in telehealth services in Australia and around the world. The rapid uptake of telehealth has mainly been due to necessity – following social distancing requirements and the need to reduce the risk of transmission. Although telehealth has been available for many decades, the COVID-19 experience has resulted in heightened awareness of telehealth amongst health service providers, patients and society overall. With increased telehealth uptake in many jurisdictions during the pandemic, it is timely and important to consider what role telehealth will have post-pandemic. In this article, we highlight five key requirements for the long-term sustainability of telehealth. These include: (a) developing a skilled workforce; (b) empowering consumers; (c) reforming funding; (d) improving the digital ecosystems; and (e) integrating telehealth into routine care.
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Affiliation(s)
- Emma E Thomas
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
| | - Helen M Haydon
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
| | - Ateev Mehrotra
- Department of Health Care Policy, Harvard Medical School, USA
| | - Liam J Caffery
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
| | - Centaine L Snoswell
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
| | - Annie Banbury
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Australia
- Centre for Health Services Research, The University of Queensland, Australia
- Centre for Innovative Medical Technology, University of Southern Denmark, Denmark
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Peterson GM, Russell G, Radford JC, Zwar N, Mazza D, Eckermann S, Mullan J, Batterham MJ, Hammond A, Bonney A. Correction to: Effectiveness of quality incentive payments in general practice (EQuIP-GP): a study protocol for a cluster-randomised trial of an outcomes-based funding model in Australian general practice to improve patient care. BMC Health Serv Res 2019; 19:581. [PMID: 31426782 PMCID: PMC6699107 DOI: 10.1186/s12913-019-4426-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In the original publication of this article [1], the first name of the 3rd author is wrong.
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Affiliation(s)
- Gregory M Peterson
- School of Medicine, University of Tasmania, Hobart and Launceston, Tasmania, Australia
| | - Grant Russell
- Department of General Practice, Monash University, Clayton, Victoria, Australia
| | - Jan C Radford
- School of Medicine, University of Tasmania, Hobart and Launceston, Tasmania, Australia
| | - Nick Zwar
- Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
| | - Danielle Mazza
- Department of General Practice, Monash University, Clayton, Victoria, Australia
| | - Simon Eckermann
- Australian Health Services Research Institute, University of Wollongong, Northfields Ave, Wollongong, NSW, Australia
| | - Judy Mullan
- School of Medicine, University of Wollongong and Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, NSW, Australia
| | - Marijka J Batterham
- Statistical Consulting Centre, School of Mathematics and Applied Statistics, University of Wollongong; National Institute for Applied Statistics Research Australia, University of Wollongong; and Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, NSW, Australia
| | - Athena Hammond
- School of Medicine, University of Wollongong, Northfields Ave, Wollongong, NSW, Australia
| | - Andrew Bonney
- School of Medicine, University of Wollongong and Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong, NSW, Australia.
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