Patientenzufriedenheit beim akuten Koronarsyndrom. Verbesserung durch die Etablierung einer Chest-Pain-Unit

TY - JOUR

T1 - Patientenzufriedenheit beim akuten Koronarsyndrom. Verbesserung durch die Etablierung einer Chest-Pain-Unit

AU - Tzikas, S

AU - Keller, T

AU - Post, F

AU - Blankenberg, S

AU - Genth-Zotz, S

AU - Münzel, T

PY - 2010/9

Y1 - 2010/9

N2 - BACKGROUND AND PURPOSE: Chest pain units (CPUs) were established primarily in the United States with the aim of reducing hospital admissions and costs, whilst improving quality of life and patient care. Clinical trials have shown that these units are safe and practical; however, there was a need to investigate to what extent patients are satisfied with the care in CPUs. The aim of this study is to evaluate the experiences of patients receiving CPU care and routine emergency department (ED) treatment for acute chest pain.PATIENTS AND METHODS: Patients presenting with acute chest pain at the ED between May 2004 and June 2005 and at the CPU between July 2005 and May 2006 were evaluated in this retrospective analysis. Standardized data collection using all available clinical data as well as telephone follow-up was carried out. Evaluation was carried out on a school-mark basis and a quality assessment was performed.RESULTS: Of the total population, 479 patients (323 male, 156 female) were treated in the ED, whereas 1176 (743 male, 433 female) in the CPU. In the ED, 26 patients (5.4%) were diagnosed as ST segment elevation myocardial infarction (STEMI), 39 (8.1%) as non-ST segment elevation myocardial infarction (NSTEMI) and 16 (3.3%) as unstable angina pectoris (UAP). In 398 patients (83.1%) acute coronary syndrome (ACS) could be ruled out. In the CPU, the incidence of STEMI was 74 (6.3%), of NSTEMI 141 (12%) and of UAP 153 (13%). ACS was excluded in 808 patients (68.7%). Data on satisfaction with in-hospital treatment was available in 78.5% of cases. In the CPU, 92.2% of the patients judged their treatment as excellent/good, 5.9% as appropriate and 1.9% as poor. The distribution of satisfaction in the ED was significantly lower with 78.6% excellent/good, 18.5% appropriate and 2.9% poor.CONCLUSION: The establishment of a CPU at the University Medical Center of Mainz demonstrated a higher level of patient satisfaction compared to the treatment of patients with acute chest pain in the general ED.

AB - BACKGROUND AND PURPOSE: Chest pain units (CPUs) were established primarily in the United States with the aim of reducing hospital admissions and costs, whilst improving quality of life and patient care. Clinical trials have shown that these units are safe and practical; however, there was a need to investigate to what extent patients are satisfied with the care in CPUs. The aim of this study is to evaluate the experiences of patients receiving CPU care and routine emergency department (ED) treatment for acute chest pain.PATIENTS AND METHODS: Patients presenting with acute chest pain at the ED between May 2004 and June 2005 and at the CPU between July 2005 and May 2006 were evaluated in this retrospective analysis. Standardized data collection using all available clinical data as well as telephone follow-up was carried out. Evaluation was carried out on a school-mark basis and a quality assessment was performed.RESULTS: Of the total population, 479 patients (323 male, 156 female) were treated in the ED, whereas 1176 (743 male, 433 female) in the CPU. In the ED, 26 patients (5.4%) were diagnosed as ST segment elevation myocardial infarction (STEMI), 39 (8.1%) as non-ST segment elevation myocardial infarction (NSTEMI) and 16 (3.3%) as unstable angina pectoris (UAP). In 398 patients (83.1%) acute coronary syndrome (ACS) could be ruled out. In the CPU, the incidence of STEMI was 74 (6.3%), of NSTEMI 141 (12%) and of UAP 153 (13%). ACS was excluded in 808 patients (68.7%). Data on satisfaction with in-hospital treatment was available in 78.5% of cases. In the CPU, 92.2% of the patients judged their treatment as excellent/good, 5.9% as appropriate and 1.9% as poor. The distribution of satisfaction in the ED was significantly lower with 78.6% excellent/good, 18.5% appropriate and 2.9% poor.CONCLUSION: The establishment of a CPU at the University Medical Center of Mainz demonstrated a higher level of patient satisfaction compared to the treatment of patients with acute chest pain in the general ED.

KW - Acute Coronary Syndrome/psychology

KW - Adult

KW - Aged

KW - Angina, Unstable/psychology

KW - Coronary Care Units/organization & administration

KW - Emergency Service, Hospital/organization & administration

KW - Female

KW - Germany

KW - Health Services Research

KW - Hospitals, University/organization & administration

KW - Humans

KW - Male

KW - Middle Aged

KW - Myocardial Infarction/psychology

KW - Patient Satisfaction

KW - Quality Assurance, Health Care/organization & administration

KW - Retrospective Studies

U2 - 10.1007/s00059-010-3366-7

DO - 10.1007/s00059-010-3366-7

M3 - SCORING: Zeitschriftenaufsatz

C2 - 20848259

VL - 35

SP - 403

EP - 409

JO - HERZ

JF - HERZ

SN - 0340-9937

IS - 6

ER -