Key result
Chest pain center accreditation is linked to ~5% higher timely STEMI reperfusion versus non-accredited hospitals.
Why the study?
Existing studies in developing countries on the impact of chest pain center accreditation on treatment quality have limited ability to demonstrate causal relationships.
Does hospital-level chest pain center accreditation improve timely reperfusion and reduce in-hospital mortality in patients with STEMI?
Observational (n=52,674)
Yes
Does hospital-level chest pain center accreditation improve timely reperfusion and reduce in-hospital mortality in patients with STEMI?
Effect estimate: 5.4% increase (95% CI 0.0333859-0.0753801)
p-value: p=<0.001
Chest pain center accreditation in China significantly improves the timeliness of reperfusion therapy for STEMI patients, though the effect diminishes over time and does not translate to a significant reduction in all-cause in-hospital mortality.
Existing studies in developing countries on the impact of chest pain center (CPC) accreditation on treatment quality have limited ability to demonstrate causal relationships. This retrospective study aims to utilize the data from national-level database and explore the impact of chest pain center certification on the treatment quality of ST-segment elevation myocardial infarction (STEMI) patients through a more appropriate method. At the hospital level, taking timely reperfusion and in-hospital mortality as outcomes, the impact was evaluated using the Counterfactual Synthetic Difference-in-Differences (CS-DID) method, a statistical technique that allows for the estimation of causal effects by comparing the differences over time between treated and non-treated groups. The results showed that CPC accreditation improved timely reperfusion of STEMI. Once a CPC was certified, without considering covariates, the timely reperfusion rate increased on average by 5.4%, the 90-min PCI rate by 7.1%, and the 30-min thrombolysis rate by 2.0% in comparison with non-accredited hospitals, and this effect shows a downward trend over time and varies between different regions. We found no evidence to confirm that CPC accreditation decreases in-hospital mortality in patients with STEMI. CPC accreditation in China has improved the timeliness of reperfusion therapy for STEMI patients. CPC accreditation and re-accreditation are crucial to maintaining high-quality care for STEMI patients.
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Yu et al. (2025) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=52,674). Chest pain center (CPC) accreditation vs. Non-accredited hospitals was evaluated on Timely reperfusion (90-min PCI or 30-min thrombolysis) (5.4% increase, 95% CI 0.0333859-0.0753801, p=<0.001). Chest pain center accreditation increased the timely reperfusion rate for STEMI patients by an average of 5.4% compared to non-accredited hospitals.
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