Mentality and organisational changes are key to developing primary angioplasty.
At the moment of signing the Stent for Life (SFL) Initiative on August 31st, 2009, it was shown that, in Serbia during 2008, 48% of patients with ST-elevation myocardial infarction (STEMI) did not receive any reperfusion and only 19% and 33% received primary percutaneous coronary intervention (p-PCI) or hospital thrombolysis, respectively. However, during 2009, there was a trend towards a substantial increase in p-PCI procedures. This was the result of the commitment of cardiologists, the contract signed by the Health Insurance Fund (HIF) for remuneration of catheterisation laboratory (cathlab) staff for each p-PCI procedure (2005), and the provision of new cathlabs by the Ministry of Health (MOH). The number of PCI centres and trained cardiologists has been rising simultaneously. Direct mobile telephone contact with interventional cardiologists has facilitated the transport of patients directly to cathlabs (from 7.5% before 2009 to 34.2% in 2010 and 2011). Although the number of patients treated with p-PCI is increasing (2006 - 647 p-PCIs; 2007 - 1,248 p-PCIs; 2008 -1,794 p-PCIs; 2009 - 2,468 p-PCIs; 2010 - 3,216 and 2011 - 3,498 p-PCIs), the percentage of patients who are treated within 120 minutes of establishing a diagnosis (first medical contact) is still not satisfactory (38%).
Serbian Academy of Sciences and Arts, Belgrade, Serbia.
Miodrag C
MC
Ostojic
Nevena D
ND
Karanovic
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000592:standards; D001291:Attitude of Health Personnel; D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D006752:Hospital Planning / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D017146:Models, Organizational; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy*; D009937:Organizational Objectives; D010348:Patient Care Team / Q000458:organization & administration; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D055771:Serbia; D015607:Stents; D013997:Time Factors; D061665:Time-to-Treatment / Q000458:organization & administration* / Q000592:standards; D016896:Treatment Outcome