Published on: 8th September 2016
Case Study 5
Learning Health Systems
Associate Prof Chris Gale, Dr Marlous Hall, Dr Kristina Laut, University of Leeds on behalf of The National Institute for Cardiovascular Outcomes Research (NICOR)
By analysing national data, researchers from The Farr Institute worked with the Universities of Leeds and York to understand how emergency procedures for heart attacks are used across the NHS.
Some patients who develop sudden chest pains undergo an emergency procedure that re-establishes blood supply in the heart in order to prevent early death from a fatal heart attack. The procedure involves insertion of a thin wire into the heart’s blood vessels on the end of which is a small balloon. Inflation of the balloon removes the blockage in the blood vessel. The balloon is then deflated and removed leaving behind a metal ring called a stent to keep the blood vessel open, allowing blood to flow freely. Although it’s an effective and often life-saving procedure, it is adopted unevenly across hospitals in England. It is important to understand why this is and to find out if anything can be done to increase how many patients receive this treatment.
A team of researchers from the Universities of Leeds and York, along with investigators from The Farr Institute, studied data on heart attacks and how they are treated. This information was gathered from all NHS hospitals in England that performed the procedure between 2003 and 2013. The data was analysed by the team to try and get to the bottom of why not all eligible patients received this procedure.
The team found that the number of patients who received the procedure increased from almost none in 2003 to 86% of those who were eligible by 2013.
They also found that the number of eligible patients who received it varied between hospitals. The data suggested that some of the lower uptake was due to pre-existing conditions such as angina, kidney failure, diseases caused by problems with the blood supply to the brain and previous heart attacks. The data also showed that people over the age of 80 were less likely to receive it and it was more common for patients that had undergone it before.
Numbers were higher among those hospitals that employed more doctors specialising in heart conditions. It was also found that numbers were higher where the procedure was available to patients 24 hours a day, 7 days a week. The researchers were able to conclude that half of this variation in uptake of the procedure was due to differences between hospitals which are still under investigation, although it is not thought that this is down to differences in staffing
By using data in research, scientists identified factors associated with the delayed uptake of this heart procedure in hospitals, providing evidence for other healthcare systems to learn from. This highlights how important it is to make sure that recommended procedures are rolled out properly across the whole country, not just in certain hospitals.
We now know that the uptake of this life saving treatment has improved dramatically between 2003 and 2013. However, there is still an opportunity to improve further. This valuable information can allow management and policy makers to enhance treatments for patients by offering the best possible procedures, saving more lives
across the country.
For further information on heart disease including steps you can take to prevent heart disease, please visit the British Heart Foundation website, www.bhf.org.uk
Enquiries to Cherry Martin, Communications Manager, The Farr Institute of
Health Informatics Research, firstname.lastname@example.org