Dr. Wendy Young and colleagues compared outcomes for 75 inner-city patients admitted to hospital with "elevated cardiac markers" (risk of heart attack) who participated in a DMP versus 71 who did not. The study found that patients in the DMP delivered by home health nurses had fewer hospitalization days per 1000 follow-up days for congestive heart failure and angina, emergency department encounters and claims for diagnostic or therapeutic services.
In a related commentary, Drs. Paul Armstrong and Robert Welsh examine current therapies for acute myocardial infarction, particularly in the context of Canadian limitations such as availability of tertiary care centres, disparities in ambulance and prehospital services. They call for a national program -- perhaps aligned with the new Health Council of Canada -- to examine and address Canada-specific issues surrounding the treatment of acute MI.
p. 905 Evaluation of a community-based disease management program for postmyocardial infarction patients -- W. Young et al
p. 925 Tailoring therapy to best suit ST-segment elevation myocardial infarction: searching for the right fit -- P.W. Armstrong, R.C. Welsh
Journal
Canadian Medical Association Journal