Metodologia para a estimativa de padrões de qualidade: o caso do infarto agudo do miocárdio

Abstract

This study outlines the steps for estimating quality standards in health care to be used in quality improvement programs and funding mechanisms, focusing on the case of acute myocardial infarction (AMI

Acute myocardial infarction: clinical and epidemiological profile and factors associated with in-hospital death in the municipality of Rio de Janeiro

“…The structure of sex and age group of the sample was similar to that reported in the literature for national studies 13,22,27 and did not vary in the sample. The median delta time observed was similar to that of another Brazilian study 27 .…”

“…In general, the 20.6% lethality found in the sample is very far from the reduced figures reached in randomized clinical trials 15 , or in selected centers 7,13 , or estimated based on a projection of efficacy of the technologies available for treating the cases 27 . However, other international studies of nonselected cases have reported high in-hospital lethality associated with acute myocardial infarction.…”

“…However, other international studies of nonselected cases have reported high in-hospital lethality associated with acute myocardial infarction. In the USA, the second National Registry of Myocardial Infarction from 1994 to 1998 reported 19.7% of deaths when no cases were excluded 27 . European multicenter studies reported 18% to 21.7% of deaths in the 1990s [10][11][12] .…”

Escore TIMI no infarto agudo do miocárdio conforme níveis de estratificação de prognóstico

“…Whatever the technique, myocardial reperfusion is the most important intervention in the management of AMI patients 3 . A Brazilian study estimated that the percentage of indicated thrombolysis in Brazil is 40% 17 . National and international studies reported that in 36.8% 17 , 39% 14 , 48% 10 and 35.1% 4 of cases, reperfusion therapy was used.…”

Análise de custo-efetividade em relação às terapias renais substitutivas: como pensar estudos em relação a essas intervenções no Brasil?

“…Partindo-se do pressuposto de que, para nosso meio, diferentemente de países desenvolvidos, a existência de um benefício marginal em termos comparativos de efetividade não é suficiente para uma tomada de decisão -assertiva fundamentada nos estudos de Silva 27,28,29 . Outros aspectos devem ser levados em consideração, como por exemplo, a operacionalização da tecnologia em determinado contexto.…”