Impact of Regional Comprehensive Cardiovascular Disease Centers on Mortality in Korea

Abstract Cardiovascular disease (CVD) remains an important global contributor to mortality and morbidity, with South Korea experiencing higher fatality rates from acute CVD despite excellent hospital care. We investigated regional CVD centers in Korea’s impact on CVD-related mortality rates. This population-based cohort study obtained data from the 2002–2019 Korean National Health Insurance Service–National Sample Cohort. Eleven of the 15 regional CVD centers were included in the study. For the 2 years pre- and post-establishment of the regional CVD centers, 15,687 patients’ data were included in the study. The inclusion criteria included (1) having consulted at an emergency room (ER) with the principal diagnosis of acute CVD, including ischemic and hypertensive CVD, and (2) residing in the area where the regional CVD center was established during the study cohort period. Patients not meeting these criteria were excluded. The dependent variable, CVD-related mortality, included mortalities occurring within 30, 60, and 90 days of the first consultation at the ER. To analyze the time trend and its change in outcomes, an interrupted time-series analysis with segmented regression was performed. There were 8,009 and 7,678 patients in the pre- and post-intervention cohorts, respectively. The probability of death within 30 days after an ER (or regional CVD center) visit among patients with acute heart disease decreased following the designation of the regional CVD center in that area (estimate, 0.9570; 95% confidence interval, 0.9213–0.9942). The designation of regional CVD centers, as part of the government health policy, reduces the acute CVD-related 30-day mortality in patients who have consulted at the ER.