Effectiveness of Coronary Care Units in Small Community Hospitals
- 1 December 1976
- journal article
- research article
- Published by American College of Physicians in Annals of Internal Medicine
- Vol. 85 (6) , 709-713
- https://doi.org/10.7326/0003-4819-85-6-709
Abstract
A prospective study was undertaken from 1969-1974 to evaluate a program establishing coronary care units in small community hospitals. Crude mortality rates from acute myocardial infarction in these small hospitals were 14.5%, slightly higher but not statistically different from concurrently collected data in 3 larger comparison hospitals (11.5%). Multivariate discriminate analysis of clinical characteristics was used to calculate a risk score for each patient admitted. Observed deaths exceeded expected deaths (134 vs. 119) (P > 0.30) in small hospitals, but observed deaths were less than expected (55 vs. 77) (P < 0.05) in comparison hospitals. Mortality was significantly greater in those units admitting < 60 patients with infarctions yearly (20.9%) than in those admitting > 60 (10.7%) (P < 0.001). Coronary care units in small community hospitals can provide adequate coronary care, but their level of performance drops when < 60 patients with infarctions are admitted yearly.Keywords
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