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Impact of Regional Cardiocerebrovascular Centers on Myocardial Infarction Patients: A Fixed-effects Model
Sang Guen Cho1 , Youngsoo Kim1 , Young Eun Choi1 , Wankyo Chung2,3
1Department of Preventive Medicine, Graduate School of Public Health, Seoul National University , Seoul, Korea
2Department of Public Health Science, Graduate School of Public Health, Seoul National University , Seoul, Korea
3Institute of Health and Environment, Seoul National University, Seoul, Korea
Corresponding Author: Wankyo Chung ,Tel: 02-880-2285, Fax: 02)762-9105, Email: wankyo@snu.ac.kr
Received: July 8, 2018;  Accepted: November 20, 2018.
ABSTRACT
Objectives:
The Regional Cardiocerebrovascular Center (RCCVC) Project designated local teaching hospitals as RCCVCs, in order to improve patient outcomes of acute cardiocerebrovascular emergencies by founding a regional system that can adequately transfer and manage patients within 3 hours. We investigated the effects of RCCVC establishment on treatment volume and 30-day mortality.
Method:
We constructed a panel dataset by extracting all acute myocardial infarction cases that occurred from 2007 to 2016 from the Health Insurance Review and Assessment Service claims data, a national and representative source. We then used a panel fixed-effect model to estimate the impacts of RCCVC establishment on patient outcomes.
Results:
We found that the number of cases of acute myocardial infarction that were treated increased chronologically, but when the time effect and other related covariates were controlled for, RCCVCs only significantly increased the number of treatment cases of women in large catchment areas. There was no statistically significant impact on 30-day mortality.
Conclusions:
The establishment of RCCVCs increased the number of treatment cases of women, without increasing the mortality rate. Therefore, the RCCVCs might have prevented potential untreated deaths by increasing the preparedness and capacity of hospitals to treat acute myocardial infarction patients.
Key words: Health Impact Assessment; Myocardial Infarction; Regional Cardiocerebrovascular Center; Fixed effects model
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