Can a Healthcare Quality Improvement Initiative Reduce Disparity in the Treatment Delay among ST-Segment Elevation Myocardial Infarction Patients with Different Arrival Modes? Evidence from 33 General Hospitals and Their Anticipated Impact on Healthcare during Disasters and Public Health Emergencies

Figures

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  Figure 1. Associations of in-hospital delay (door-to-balloon time of >90 min) with accreditation status and arrival mode. Abbreviations: 95% CI, 95% confidence interval; EMS, emergency medical service. Notes: Both Models 1 and 2 were adjusted for sex, age, signs and symptoms at presentation, heart rate, blood pressure and Killip class, arrival mode, time of day of arrival, day of arrival, class of hospital, region of hospital, and accreditation status. Model 1 did not contain an interaction term. Model 2 included an interaction term of arrival mode and accreditation status. The OR value of the interaction term indicates that the decreased likelihood of door-to-balloon time being more than 90 min associated with accreditation status for EMS-transported patients was (OR − 1) ∗ 100%-more than that for walk-in patients.

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  Figure 2. Associations of door-to-balloon time with accreditation status and arrival mode. Abbreviations: 95% CI, 95% confidence interval; EMS, emergency medical service. Notes: Both Model 1 and 2 were adjusted for sex, age, signs and symptoms at presentation, heart rate, blood pressure and Killip class, arrival mode, time of day of arrival, day of arrival, class of hospital, region of hospital, and accreditation status. Model 1 did not contain an interaction term. Model 2 included an interaction term of arrival mode and accreditation status. The β value of the interaction term indicates that the decrease in door-to-balloon time associated with accreditation status for EMS-transported patients was β minutes more than that for walk-in patients.