MSGID: 1:317/3 6274a4dc   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Heart attack mortality rate higher in the US compared to other high-   
   income countries    
      
     Date:   
         May 5, 2022   
     Source:   
         University of Texas Medical Branch at Galveston   
     Summary:   
         When it comes to treating heart attacks, U.S. hospitals may have   
         the latest tech and low readmission rates, but the country's   
         mortality rate is one of the highest among the nations included   
         in a new study. The study found substantial differences in care   
         for heart attack patients across six high income countries despite   
         international agreement on how heart attacks should be treated.   
      
      
      
   FULL STORY   
   ==========================================================================   
   When it comes to treating heart attacks, U.S. hospitals may have the   
   latest tech and low readmission rates, but the country's mortality rate   
   is one of the highest among the nations included in a new study.   
      
      
   ==========================================================================   
   The study, published May 4 in The BMJ, found substantial differences in   
   care for heart attack patients across six high income countries despite   
   international agreement on how heart attacks should be treated.   
      
   "No health care system seemed to be excelling in every aspect of heart   
   attack care," said Dr. Peter Cram, professor and chair of internal   
   medicine at the University of Texas Medical Center at Galveston, who is   
   one of the authors of the study.   
      
   Cram and collaborator Dr. Bruce Landon from Harvard developed the   
   International Health System Research Collaborative to compare treatment   
   and outcomes across high income countries. For this particular study, they   
   examined data for patients 66 and older who were admitted to a hospital   
   with a heart attack in six high income countries between 2011 and 2017.   
      
   The countries they compared were the United States, Canada, England,   
   Netherlands, Israel and Taiwan. Researchers chose these countries   
   because they all have highly developed healthcare systems and accessible   
   administrative data, but they differ in their financing, organization   
   and overall performance in international rankings.   
      
   Researchers chose to look at heart attacks, a common condition with   
   established international diagnostic criteria and consensus about   
   evidence-based treatments that is easy track with widely available data.   
      
      
      
   ==========================================================================   
   While the United States did well with cardiac revascularization --   
   procedures to treat blockages in the coronary arteries -- and had low   
   hospital readmission rates, the U.S. mortality rate along with Taiwan   
   was higher than other countries and "concernedly high," Cram said.   
      
   "The U.S. seems to focus really hard on those technologically advanced   
   new and shiny things," he said. "Maybe, from a policy perspective, we   
   should focus more on the mortality rate instead of getting people in   
   and out of the hospital."  By comparison, England and the Netherlands   
   seemed to have lower mortality but far lower revascularization rates.   
      
   "It seems to be about tradeoffs," Cram said. "Israel really seemed to   
   be an exception, the only country that really seemed to perform well   
   across all measures."  The data is revealing.   
      
      
      
   ==========================================================================   
   "We previously didn't know this," Cram said. "We should be comparing   
   ourselves to high-income countries as a mechanism for identifying where we   
   are performing well and where we should focus our improvement efforts."   
   What accounts for the higher mortality rate after one year for heart   
   attack patients in the United States and Taiwan is not clear.   
      
   "What is happening to our patients who have had heart attacks after they   
   leave the hospital?" Cram said. "Is it gaps in wealth? Is it obesity   
   rates? Is it people not taking recommended medications? We don't know."   
   But the questions point to where more research is needed.   
      
   "From a U.S. perspective, our heart attack care is good, but the one-year   
   mortality rate is concerning," Cram said. "If dying is one of the things   
   we want to prevent, then we have work to do."   
      
   ==========================================================================   
   Story Source: Materials provided by   
   University_of_Texas_Medical_Branch_at_Galveston. Note: Content may be   
   edited for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Peter Cram, Laura A Hatfield, Pieter Bakx, Amitava Banerjee,   
      Christina   
         Fu, Michal Gordon, Renaud Heine, Nicole Huang, Dennis Ko, Lisa M   
         Lix, Victor Novack, Laura Pasea, Feng Qiu, Therese A Stukel, Carin   
         Uyl de Groot, Lin Yan, Bruce Landon. Variation in revascularisation   
         use and outcomes of patients in hospital with acute myocardial   
         infarction across six high income countries: cross sectional cohort   
         study. BMJ, 2022; e069164 DOI: 10.1136/bmj-2021-069164   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2022/05/220505143829.htm   
      
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