BACKGROUND: Important differences exist between European countries in the degree of implementation of primary percutaneous coronary intervention (PPCI) for patients with ST-elevation myocardial infarction (STEMI). To investigate whether health care-associated economic and demographic country-level characteristics were associated with differences in utilization of PPCI, we aimed to examine 5-year trends in the implementation of PPCI for STEMI across 12 EU countries. METHODS: An ecological study of aggregated data from national and international registries. Main outcome was the number of PPCI per 1,000,000 population, collected annually for the years 2003 to 2008. Impact of year on PPCI implementation was modeled using linear regression and mixed effects models used to quantify associations between PPCI use and country-level parameters. RESULTS: The annual growth in utilization of PPCI was 1.11 (1.03,1.20) per million. Country-level utilization rates varied from 0.82 (95% CI 0.52, 1.30) to 1.38 (95% CI 1.15, 1.64) per million per year. Number of physicians per 100,000 population, number of nurses and midwifes per 100,000 population, number of acute care beds per 100,000 population, population density per km(2), and proportion of population under 50 years old were associated with PPCI utilization. CONCLUSIONS: All 12 EU countries demonstrated evidence of PPCI implementation from 2003 to 2008. However, there was substantial variation in the use and rate of uptake of PPCI between countries. Differences in utilization rates of PPCI are associated with supply factors, such as numbers of beds and physicians, rather than healthcare economic characteristics. Further studies are needed to explore the influence of patient-level factors.
BACKGROUND: Important differences exist between European countries in the degree of implementation of primary percutaneous coronary intervention (PPCI) for patients with ST-elevation myocardial infarction (STEMI). To investigate whether health care-associated economic and demographic country-level characteristics were associated with differences in utilization of PPCI, we aimed to examine 5-year trends in the implementation of PPCI for STEMI across 12 EU countries. METHODS: An ecological study of aggregated data from national and international registries. Main outcome was the number of PPCI per 1,000,000 population, collected annually for the years 2003 to 2008. Impact of year on PPCI implementation was modeled using linear regression and mixed effects models used to quantify associations between PPCI use and country-level parameters. RESULTS: The annual growth in utilization of PPCI was 1.11 (1.03,1.20) per million. Country-level utilization rates varied from 0.82 (95% CI 0.52, 1.30) to 1.38 (95% CI 1.15, 1.64) per million per year. Number of physicians per 100,000 population, number of nurses and midwifes per 100,000 population, number of acute care beds per 100,000 population, population density per km(2), and proportion of population under 50 years old were associated with PPCI utilization. CONCLUSIONS: All 12 EU countries demonstrated evidence of PPCI implementation from 2003 to 2008. However, there was substantial variation in the use and rate of uptake of PPCI between countries. Differences in utilization rates of PPCI are associated with supply factors, such as numbers of beds and physicians, rather than healthcare economic characteristics. Further studies are needed to explore the influence of patient-level factors.
Authors: Judith Kämpfer; Andriy Yagensky; Tomasz Zdrojewski; Stephan Windecker; Bernhard Meier; Mykhailo Pavelko; Iryna Sichkaruk; Piotr Kasprzyk; Marzin Gruchala; Mikael Giacomini; Lukas Räber; Hugo Saner Journal: BMJ Open Date: 2017-08-11 Impact factor: 2.692
Authors: Owen Bebb; Marlous Hall; Keith A A Fox; Tatendashe B Dondo; Adam Timmis; Hector Bueno; François Schiele; Chris P Gale Journal: Eur Heart J Date: 2017-04-01 Impact factor: 29.983
Authors: Tatendashe Bernadette Dondo; Marlous Hall; Theresa Munyombwe; Chris Wilkinson; Mohammad E Yadegarfar; Adam Timmis; Philip D Batin; Tomas Jernberg; Keith Aa Fox; Chris P Gale Journal: Heart Date: 2019-11-15 Impact factor: 5.994
Authors: Sheng-Chia Chung; Rolf Gedeborg; Owen Nicholas; Stefan James; Anders Jeppsson; Charles Wolfe; Peter Heuschmann; Lars Wallentin; John Deanfield; Adam Timmis; Tomas Jernberg; Harry Hemingway Journal: Lancet Date: 2014-01-23 Impact factor: 79.321
Authors: M Hall; K Laut; T B Dondo; O A Alabas; R A Brogan; N Gutacker; R Cookson; P Norman; A Timmis; M de Belder; P F Ludman; C P Gale Journal: Heart Date: 2016-01-05 Impact factor: 5.994