High quality process of care increases one-year survival after acute myocardial infarction (AMI): A cohort study in Italy

38,517 incident cases of acute myocardial infarction (AMI) aged 18-100 years from health information systems during 2011-2014 in the Lazio region of Italy. Mean age 73 years, 61.8% men, 29% with diabetes, and 21% with COPD.

Highest level of quality of care across the multicomponent continuum: emergency timeliness (travel time <10 minutes), hospitalization in a high-performance hospital (high proportion and timeliness of PCI on STEMI), and complete evidence-based drug therapy in the post-acute phase (3-4 drugs among antiplatelets, beta-blockers, ACE inhibitors/ARBs, statins).

Worst level of quality of care: emergency timeliness ≥10 minutes, hospitalization in a low-performance hospital, and suboptimal drug therapy (<3 evidence-based drugs).

1-year survival probability (calculated as the product of the probability to reach the hospital, 30-day survival from admission, and 31-365 days survival post-discharge).hard clinical