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European Heart Journal 2002 23(11):858-868; doi:10.1053/euhj.2001.3080
Copyright © 2002 by the European Society of Cardiology.
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European comparison of costs and quality in the treatment of acute myocardial infarction (2000–2001)

A. Gandjoura,f1, F. Kleinschmitb and K.W. Lauterbacha INTERCARE Iternational Investigators

a Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany
b Johanniter Hospital, Department of Medicine I, Duisburg, Germany
Michael Drummond, Centre for Health Economics, University of York, York, U.K.

revised November 2, 2001; accepted November 7, 2001

Abstract

Aims To compare the inpatient costs and process quality in the treatment of acute myocardial infarction in France, Germany, Italy, The Netherlands, Sweden, Switzerland, and the U.K.

Methods A total of 208 European hospitals assessed services for one hypothetical average patient with acute myocardial infarction (cost evaluation) and prospectively followed up one or two real acute myocardial infarction patients (quality evaluation) in 2000/2001. The following cost modules were evaluated: general medicine ward, critical care unit (both personnel costs only), and reperfusion therapy. The following process quality indicators were evaluated: reperfusion therapy; and prescription of aspirin, lidocaine, beta-blockers, and ACE inhibitors.

Results Switzerland, Germany, and France had the highest reperfusion costs due to a relatively high percentage of patients receiving percutaneous transluminal coronary angioplasties, stents, and glycoprotein IIb/IIIa blockers. Personnel costs for general medicine wards and critical care units were highest in Italy and Germany due to relatively long hospital stays. Average quality ratings ranged from 89% in the U.K. and France to 96% in Germany.

Conclusion There was little variation in the process quality of care for treating acute myocardial infarction. Differences in resource use may result from differences in the types of reimbursement and in the rates of diffusion of new technology. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Key Words: Myocardial infarction, quality, costs, Europe

f1 Correspondence: Dr Gandjour, Institut für Gesundheitsökonomie und Klinische Epidemiologie, Universität zu Köln, Gleueler Straße 176-178, 50935 Köln, Germany.

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