Projects / Programmes
Secondary prevention and quality of care of myocardial infarction in Slovenian hospitals, and the impact of the COVID-19 pandemic on the management of atherosclerotic vascular disease
| Code |
Science |
Field |
Subfield |
| 3.06.00 |
Medical sciences |
Cardiovascular system |
|
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
Atherosclerosis; Myocardial infarction; Secondary prevention; Quality Indicators, Health Care; COVID-19
Researchers (7)
Organisations (3)
Abstract
Atherosclerotic vascular diseases — including myocardial infarction, cerebrovascular disease, peripheral artery disease and aortic aneurysm — are a leading cause of morbidity and mortality in Slovenia and worldwide. Management of atherosclerosis includes acute/hospital care (reperfusion therapies) and long-term management (secondary prevention), which may be measured by dedicated quality process and outcome indicators. Indicators may be captured by superior—but resource- and time-intensive—dedicated research and clinical registries, or by inferior—but routinely available and sustainable—administrative reimbursement-claim data. A comprehensive quality appraisal of atherosclerosis care through administrative data has not been performed so far. Main project goals are to provide a comparative quality appraisal of hospital care in patients with myocardial infarction (goal C1) and other types of atherosclerosis (goal C2), in relation to patient and hospital characteristics, socio-economic factors and the coronavirus disease 19 (COVID-19) pandemic. Concomitantly, we aim to develop and validate an accessible, sustainable and systematic methodology for healthcare quality appraisal based on routinely collected reimbursement-claim data (goal C3). The project comprises a primary research and ancillary validation/explorative research. The primary research will merge databases on hospital activity, medicines reimbursement, residential rehabilitation and outpatient activity, which are routinely collected by the national Health Insurance Institute of Slovenia. The research will appraise process quality (uptake of interventions, medicines and rehabilitation) and outcomes (mortality and hospital admissions) in hospitalised patients with atherosclerotic vascular disease. Independent (exploratory) variables to be studied include patients’ characteristics (medical and public health perspective), hospital characteristics (healthcare system perspective), neighbourhood factors (socio-economic perspective) and the impact of the COVID-19 pandemic. Ancillary validation research will appraise the validity of administrative data against data derived from dedicated research in patents with myocardial infarction, from a clinical registry of patients undergoing cardiac rehabilitation, and from an opportunistic analysis of discharge documentation in patients with peripheral artery disease. Ancillary explorative research will provide quantitative and qualitative appraisal of patients’ perspective on the impact of the COVID-19 pandemic on their care. The project will be carried out in compliance with medical ethics (Slovenian Medical Ethics Committee approval No. 0120-223/2021/4) and data protection legislative frameworks. The project will deliver 1) a focused appraisal of quality of care in patients hospitalised because of myocardial infarction in Slovenia; 2) an extended appraisal of quality of care in patients hospitalised because of any atherosclerotic vascular disease in Slovenia; 3) a validated methodology for appraisal of healthcare quality based on routinely collected reimbursement-claim data. Deliverables will be provided to contracting authorities (i.e., the Ministry of health of the Republic of Slovenia and the Slovenian Research Agency) in form of preliminary and final reports, presented to the professional community (hospitals and professional associations) at meetings, and submitted for publication to peer-reviewed journals.
