Tehran University Medical Journal

Background and Aim: Quality of care and its concordance with scientific evidence has a significant role in improvement of prognosis in patients with acute coronary syndrome (ACS). The present study was performed to evaluate the quality of care in a TUMS-affiliated hospital.

Materials and Methods: The quality indicators of the process and outcome of care according to guidelines of the MONICA project was used in this study. 320 cases with primary impression of ACS (including 80 cases from each trimester during Aug-2003 to Jul-2004) were evaluated according to MONICA standard definitions of diagnosis, provided care and survival in 28th day after heart attack.

Results: The Equivalent Treatment Score (ETS) was 43.4 percent (95%CI: 32.86-53.94) and the Weighted Treatment Score (WTS) was 22.2 percent (95%CI: 13.36-31.03) in patients with definite myocardial infarction. The 28-day case fatality among the evaluated patients was 9.09 percent (95%CI: 5.85-12.33).

Conclusion: Although the measures of quality of care in this patient setting were acceptable in comparison with MONICA collaborative centers, however the difference between ways of hospital sampling (in the present study) and the population-based method (applied in the MONICA populations) should be taken in to consideration. Adding pre-hospital fatal events to this data set will decrease the precision of quality measures.