Cardiovascular diseases are the main cause of death in Argentina, particularly myocardial infarction (MI). There are health strategies that improve survival in the acute stage of myocardial infarction, such as the establishment of referral networks for acute treatment, the application of referral algorithms and treatment. In the town of Florencio Varela (FV), located in the southern conurbation of the Province of Buenos Aires (PBA), there is a hospital network made up of four municipalities. In the last decade, a network referral program was implemented for MI care based on emergency referral according to a consensual algorithm for acute reperfusion of MI. However, delays persist in the articulation of consultations with the first level of care and in referrals to the most complex effector.
An implementation research study is proposed that includes an intervention based on the use of information and communication technologies (ICTs), decision support, the use of diagnostic and referral algorithms, and the incorporation of the first level of care, primary health-care centres , and the emergency ambulance system (SAME) of the Municipality of FV into the MI referral network.
1) To evaluate the implementation of an Integrated Networked Program for MI Care that includes all levels of health care in the municipality of FV. 2) Evaluate the effectiveness of a multi-component intervention for MI care coordination and care.
A type 3 hybrid design will be used to evaluate the implementation and effectiveness of a controlled intervention using the interrupted series methodology. A mixed methodological approach will be used. The qualitative component will be used to assess the acceptability, adaptability and feasibility of the intervention, and the sustainability of the Programme through semi-structured individual interviews. The quantitative component will be used to assess the effect of the intervention.
With the implementation of this strategy it is expected to increase the number of heart attacks diagnosed by the public health system, increase the proportion of patients reperfused in the acute stage, and reduce delays to reperfusion. If this strategy is successful, it could be scaled up to many other regions of the country with similar health structures and problems.”
- Argentina Ministry of Health, Argentina
Carlos Daniel Tajer