Analysis Of Current Situation And Effect Of Follow-up Patients With Pci And CABG

Coronary heart disease is the first cause of death in the world and it also cause the most hospitalization of cardiovascular diseases in Beijing. With the increase in number of patients and the development of surgical technique, patients after percutaneous coronary intervention( PCI) and coronary artery bypass grafting(CABG) increased year by year.Objectives:To provide a scientific reference for the follow-up status of patients who has went though PCI or CABG by explicit description of the postoperative follow-up on patients with coronary heart disease.Methods:We selected the patients with health care in Beijng, who went through PCI(ICD: 36.07003) or CABG(ICD:36.10001、36.11001、36.12001、36.13001、36.14001、36.15001、36.16001) and discharged from January 1, 2013 to December 31, 2013 in Beijing Anzhen Hospital, Capital Medical University. We got 3151 cases by excluding the patients who died before hospital discharge or once had the same surgery, those patients without follow-up information were also removed. This study of medicare patients were identified by health insurance card number and the date information was based on the double-blind principle. In selected 100 cases randomly, the surgery name in record information is consistent with the original surgical record.After the desensitization of personal privacy in the date, the follow-up information of patients in Beijing Anzhen Hospital and the cooperation hospitals in 12 months was used in our study To calrify the follow-up status,We describe the follow-up rate of every month, and analysis the tendency in different levels of hospitals.After 6 months, we divide the follow-up hospitals into three groups-the second-class and above hospitals, union group and the community health service group.We judged the effect of follow-up through the standardability of drug threapy, safety and economy. The standardability is evaluated by the medication rate of recommend secondary prevention drugs followed the guidelines. The safety is estimated by the incidence of major adverse cardiac events. The economy is appraised by clinic fees and hospital costs.MACE(Major adverse cardiac events, MACE) include recurrent myocardial infarction, revascularization, UA(unstable angina, UA), gastrointestinal bleeding, and cerebrovascular events.Results:Totally 3151 patients were collected in this study. The number of PCI patients is 2349 and the number of CABG patients is 757.The follow-up number of return visit was 49930 and 17.81% in the community health service center.A total of 240 cases were occured during the following 12 months.andthe average MACE rate was 7.62%.There was no statistical significant differences between the three groups. The average of outpatient medical expenditure was 8724 yuan and re-hospitalization cost was 37801 yuan.Patients in the second-class and above hospitals group cost the most in outpatient follow-up visit, while the hospitalization expenses showed no statistical significant differences.Conclusions:The follow-up of patients who has went though PCI or CABG were more inclined to second-class and above hospitals. Follow-up in community health service not only guaranteed the safety but also lower the outpatient expense.