Treatment of acute myocardial infarction in the sub-arctic region of Norway. Do we offer an equal quality of care?

ABSTRACT

Patients, relatives, healthcare workers and administrators are concerned about the quality of care offered. We aimed to explore the treatment of acute myocatrdial infarction (AMI) in Northern Norway, compare it with the national figures, and document whether there is an equal quality of care or not. The retrospective study included data on patients' treatment for AMI. The following sources were employed. The Norwegian Patient Registry, National Quality of Care Database, Norwegian Myocardial Infarction Registry and data from the National Air Ambulance Services of Norway. The period 2012-2014/15 was studied and the variables were: incidence of AMI, gender and age adjusted rates of AMI and revascularization (PCI, CABG) based on patient's place of living (according to hospital catchment area) and 30-day survival rate. The annual incidence of AMI was 9% higher in the northern region. Significant incidence variations (2.7–5.9 AMI/1000 inhabitants) between the hospitals' catchment areas were revealed. The 30-day survival rate varied between 85.1–92.1% between hospitals. The variation in revascularization/AMI rate was 0.72–1.54. Air amublance services' availability varied through the day. In conclusion, significant variations in the AMI rate and an unequal service within the region was revealed.

KEYWORDS:

• Acute myocardial infarction
• Norway
• incidence
• service
• air ambulance

Acknowledgements

We are thankful to our colleagues who have answered several questions and commented on many of our suggestions. We are also grateful for the assistance in the analysis of false discovery rate (FDR) by Tonya M. Hansen, Department of Quality and Patient Safety, Norwegian Institute of Public Health, Oslo, Norway.

Conflict of interests

The authors confirm that there are no conflicts of interest associated with this publication. The authors, their immediate family and any research foundation with which they are affiliated did not receive any financial payments or other benefits from any commercial entity related to the subject of this article. There was no outside funding or grants received that assisted in this study.

Publication/presentation

The study or its data has not been sent to or published in any medical journal. It was presented as a poster (Q84) at the International Forum on Quality & Safety in Health Care in London, April 2017.

Additional information

Funding

The Northern Norway Regional Health Authority trust covered the cost of travelling and arrangements of necessary meetings during the study period.The publication charges for this article have been funded by a grant from the publication fund of UiT - The Arctic University of Norway.