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学科主题临床医学
System Barriers to the Evidence-Based Care of Acute Coronary Syndrome Patients in China Qualitative Analysis
Ranasinghe, Isuru1; Rong, Ye1; Du, Xin2,3; Wang, Yangfang4; Gao, Runlin5,6; Patel, Anushka1; Wu, Yangfeng2,4; Iedema, Rick7; Hao, Zhixin2; Hu, Dayi8; Turnbull, Fiona1; CPACS Investigators
关键词acute coronary syndrome quality of health care
刊名CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES
2014-03-01
DOI10.1161/CIRCOUTCOMES.113.000527
7期:2页:209-216
收录类别SCI ; SSCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Cardiac & Cardiovascular Systems
研究领域[WOS]Cardiovascular System & Cardiology
关键词[WOS]ACUTE MYOCARDIAL-INFARCTION ; RISK STRATIFICATION ; HEART-DISEASE ; HEALTH-CARE ; HOSPITALS ; CHALLENGES ; PATTERNS ; MEDICINE ; REFORM ; RATES
英文摘要

Background-

Organizational and wider health system factors influence the implementation and success of interventions. Clinical Pathways in Acute Coronary Syndromes 2 is a cluster randomized trial of a clinical pathway-based intervention to improve acute coronary syndrome care in hospitals in China. We performed a qualitative evaluation to examine the system-level barriers to implementing clinical pathways in the dynamic healthcare environment of China.

Methods and Results-

A qualitative descriptive analysis of 40 in-depth interviews with health professionals conducted in a sample of 10 hospitals purposively selected to explore barriers to implementation of the intervention. Qualitative data were analyzed using the Framework method. In-depth interviews identified 5 key system-level barriers to effective implementation: (1) leadership support for implementing quality improvement, (2) variation in the capacity of clinical services and quality improvement resources, (3) fears of patient disputes and litigation, (4) healthcare funding constraints and high out-of-pocket expenses, and (5) patient-related factors.

Conclusions-

System-level barriers affect the ability of acute coronary syndrome clinical pathways to change practice. Addressing these barriers in the context of current and planned national health system reform will be critical for future improvements in the management of acute coronary syndromes, and potentially other hospitalized conditions, in China.

Clinical Trial Registration-

URL: http://www.anzctr.org.au/default.aspx. Register. Unique identifier: ACTRN12609000491268.

语种英语
WOS记录号WOS:000332962100003
资助机构Sanofi-Aventis China
引用统计
被引频次:18[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/59363
专题北京大学临床研究所
作者单位1.NSW Minist Hlth, Agcy Clin Innovat, Sydney, NSW, Australia
2.Univ Sydney, George Inst Global Hlth, Div Cardiovasc, Sydney, NSW 2006, Australia
3.Peking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing 100871, Peoples R China
4.Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China
5.Peking Univ, Hlth Sci Ctr, Clin Res Inst, Beijing 100871, Peoples R China
6.Chinese Acad Med Sci, Cardiovasc Inst, Dept Cardiol, Peking Union Med Coll, Beijing 100730, Peoples R China
7.Chinese Acad Med Sci, Fuwai Hosp, Peking Union Med Coll, Beijing 100730, Peoples R China
8.Peking Univ, Peoples Hosp, Dept Cardiol, Beijing 100871, Peoples R China
推荐引用方式
GB/T 7714
Ranasinghe, Isuru,Rong, Ye,Du, Xin,et al. System Barriers to the Evidence-Based Care of Acute Coronary Syndrome Patients in China Qualitative Analysis[J]. CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES,2014,7(2):209-216.
APA Ranasinghe, Isuru.,Rong, Ye.,Du, Xin.,Wang, Yangfang.,Gao, Runlin.,...&CPACS Investigators.(2014).System Barriers to the Evidence-Based Care of Acute Coronary Syndrome Patients in China Qualitative Analysis.CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES,7(2),209-216.
MLA Ranasinghe, Isuru,et al."System Barriers to the Evidence-Based Care of Acute Coronary Syndrome Patients in China Qualitative Analysis".CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES 7.2(2014):209-216.
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