Key result
Larger coronary-care units in teaching hospitals with full-time directors showed lower mean case fatality rates from myocardial infarction, though differences were often not statistically significant.
Why the study?
Do larger coronary-care units in teaching hospitals with full-time directors improve outcomes and efficiency compared to other units?
Observational
Yes
Do larger coronary-care units in teaching hospitals with full-time directors improve outcomes and efficiency compared to other units?
Regional planning of coronary-care units may be necessary to assure effectiveness and economy, as larger teaching hospital units show trends toward better outcomes and efficiency.
Trends favoring larger teaching CCUs with full-time directors for MI remain inconclusive; randomized studies needed before changing unit organization.
The use of coronary-care units for the treatment of patients with myocardial infarction has increased explosively with little attention to efficacy, need, or cost. A study of 32 hospital units revealed that half the patients treated did not have myocardial infarctions and were a very low-risk group. Larger units in teaching hospitals with full-time directors showed lower mean case fatality rates from myocardial infarction, higher percentages of patients with infarction and greater productivity and efficiency. These important differences were often not statistically significant because of the great variation within hospital groups. Intensive care for patients after myocardial infarction should be planned by region, not by individual hospitals, to assure effectiveness and economy. Intensive care of such patients presents an ideal model for regional planning. Finally, proof of effectiveness of intensive care in these cases is lacking.
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Bloom et al. (1973) conducted an observational in Myocardial infarction. Coronary-care units vs. Other hospital units was evaluated on Case fatality rates from myocardial infarction. Larger coronary-care units in teaching hospitals with full-time directors showed lower mean case fatality rates from myocardial infarction, though differences were often not statistically significant.
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