Holiday Impact on Trends in Quality of Acute Coronary Syndrome Care
Ruize Guo1, Mengyang Liu1, Lei Yu1
1Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, China.
Insights
Acute coronary syndrome (ACS) care quality improves overall, but declines during the Spring Festival holiday. Excluding holiday effects, adherence to quality indicators for ACS treatment shows a positive trend, highlighting progress in integrated care and collaboration.
Area of Science:
- Cardiology
- Healthcare Quality
- Public Health
Background:
- Acute coronary syndrome (ACS) presents significant morbidity and mortality risks.
- Timely intervention is crucial for reducing ACS mortality.
- Holiday periods may negatively impact the quality of ACS care.
Purpose of the Study:
- To analyze trends in the quality of ACS treatment.
- To investigate the impact of the Spring Festival holiday on ACS care quality.
Main Methods:
- Joinpoint regression analyzed quality indicator (QI) adherence trends from January 2016 to June 2020.
- Average monthly percentage change (AMPC) quantified trends in emergency care quality.
- Interrupted time series (ITS) assessed the Spring Festival's holiday effect.
Main Results:
- Five QIs (QI2, QI4, QI5, QI7, QI8) demonstrated a consistent upward trend.
- QI4 showed the most rapid increase (AMPC = 24.31%).
- The Spring Festival led to immediate changes in all nine QIs, with QI5 decreasing by 13.94% and QI4 increasing by 27.71% in specific phases.
Conclusions:
- ACS care quality decreases around the Spring Festival.
- Excluding holiday impacts, ACS care quality shows improvement.
- Enhanced integrated care and multidisciplinary collaboration are key drivers of improved ACS care quality.
Background:
Acute coronary syndrome (ACS) is a common and serious cardiovascular disease with high morbidity and mortality. Timely diagnosis and treatment can help reduce the mortality of patients, but the arrival of the holidays may affect the quality of ACS treatment.
Objectives:
To analyse the trends in the treatment quality of ACS care and the holiday season effect.
Methods:
Joinpoint regression was performed to measure the overall trend in adherence rate of QIs from 1 January 2016, to 30 June 2020. The trends in emergency care quality over time was quantised by average monthly percentage change (AMPC). Interrupted time series were used to analyse the holiday season effect of the Spring Festival.
Results:
The completion rates of five QIs (QI2, QI4, QI5, QI7, QI8) showed a continuous upward trend between 1 January 2016 and 30 June 2020, with QI4 showing the fastest upward trend between month 35 and month 38 (AMPC = 24.31%, p < 0.05). The completion rates of QI3, QI6 and QI9 showed an increasing trend at the beginning of the study and a decreasing trend at the later stages. Results of ITS model showed that there were immediate changes in rates of nine QIs before and after Chinese Spring Festival, with the largest decrease was in QI5 in phase 2 (level change = -13.94%, p < 0.05) and the highest increase was in QI4 in phase 4 (level change = 27.71%, p < 0.05). Excluding the effects of the holiday, completion rates continue to increase across the eight QIs.
Conclusions:
Quality of care in ACS declined around the Spring Festival. Excluding the effect of holidays, the quality of ACS disease care showed an improving trend, especially in integrated care and multidisciplinary collaboration.
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