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January 9, 2026Journal of Epidemiology & Community Health

Scalable regionalised quality improvement model for ACS management in resource-limited primary healthcare facilities

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Key result

CPU referral reduced in-hospital heart failure by 84% (OR 0.16) and mortality by 32% (OR 0.68), while also shortening DIDO and onset-to-door times in ACS patients.

Authors

ZWZongbin WangYZYan ZhangLZLong Zhang

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Overview

Retrospective cohort study shows improved outcomes for ACS patients in resource-limited settings, suggesting a need for quality enhancement strategies.

Key Points

  • The study aimed to evaluate the impact of a regionalised quality improvement model on acute coronary syndrome management in primary healthcare settings.
  • Retrospective cohort study using registry data from the Chinese Cardiovascular Association Database
  • Included ACS patients referred from primary healthcare facilities to chest pain centres
  • Compared standardised CPU referral protocols with routine referral methods
  • Utilized propensity score matching and generalised linear mixed models for analysis
  • CPU referral group had significantly lower odds of in-hospital heart failure (OR 0.16) and mortality (OR 0.68)
  • Shorter DIDO time (β=−0.33) and reduced time from onset to CPC arrival (β=−0.19)
  • Improved first medical contact time and door-to-balloon time
  • Higher adherence to recommended discharge medications, reduced length of stay, and decreased hospital costs

Cite This Study

Wang et al. (2026) studied this question. CPU referral reduced in-hospital heart failure by 84% (OR 0.16) and mortality by 32% (OR 0.68), while also shortening DIDO and onset-to-door times in ACS patients.

synapsesocial.com/papers/696128ef44c2cd6c68456bfehttps://doi.org/10.1136/jech-2025-225229
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Also Consider

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  3. 32-053 Optimising catheter lab efficiency with non-invasive cardiac testing for stable chest pain patients: a quality improvement project2025
  4. 4Prehospital 12-lead ECG and outcomes in acute coronary syndrome2025 · 2 citations
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