{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T15:51:46Z","timestamp":1764431506375,"version":"build-2065373602"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2010,1,26]],"date-time":"2010-01-26T00:00:00Z","timestamp":1264464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Previous studies have examined differences in care for acute myocardial infarction (AMI) according to patient characteristics such as age, gender, or insurance, but little attention has been given to whether admission source is related to guideline adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>To investigate: (1) the use of aspirin and reperfusion in the care of post\u2010acute\/long\u2010term care (PAC\/LTC) patients who are hospitalized for AMI, and (2) 30\u2010day mortality associated with these treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>DESIGN:<\/jats:title><jats:p>Secondary examination of data from the Cooperative Cardiovascular Project (CCP) national baseline data.<\/jats:p><\/jats:sec><jats:sec><jats:title>SETTING:<\/jats:title><jats:p>A total of 4013 U.S. hospitals.<\/jats:p><\/jats:sec><jats:sec><jats:title>SUBJECTS:<\/jats:title><jats:p>Patients hospitalized with a confirmed AMI admitted from PAC\/LTC (n = 8151) or community\u2010dwelling (n = 120,032) settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>MEASUREMENTS:<\/jats:title><jats:p>Early administration of aspirin and reperfusion via either thrombolysis or percutaneous intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>PAC\/LTC patients were less likely to receive treatment for AMI, even after adjustment for multiple variables associated with treatment choice. Differences persisted with additional econometric adjustment using seemingly\u2010unrelated regression. Multivariable logistic regression results indicated that aspirin was related to improved 30\u2010day survival for both PAC\/LTC and community admissions (odds ratio [OR], 0.50; 95% confidence interval [CI], 0.43\u20100.58 for PAC\/LTC, and OR, 0.57; 95% CI, 0.54\u20100.60 for community). Reperfusion was associated with higher ORs for mortality for eligible patients admitted from community setting (OR, 1.24; 95% CI, 1.13\u20101.35), but ideally\u2010eligible candidates had lower ORs for mortality (OR, 0.58; 95% CI, 0.35\u20100.95 for PAC\/LTC, and OR, 0.74; 95% CI, 0.68\u20100.81 for community).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Patients transferred from PAC\/LTC settings were less likely to receive early treatment for AMI than other patients. Future trials should inform which guidelines are applicable to PAC\/LTC patients. Journal of Hospital Medicine 2010;5:E3\u2013E10. \u00a9 2010 Society of Hospital Medicine.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.622","type":"journal-article","created":{"date-parts":[[2010,1,26]],"date-time":"2010-01-26T16:01:15Z","timestamp":1264521675000},"source":"Crossref","is-referenced-by-count":4,"title":["Examining guideline\u2010concordant care for acute myocardial infarction (AMI): The case of hospitalized post\u2010acute and long\u2010term care (PAC\/LTC) residents"],"prefix":"10.1002","volume":"5","author":[{"given":"Tiffany A.","family":"Radcliff","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cari R.","family":"Levy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,1,26]]},"reference":[{"volume-title":"The Characteristics of Long\u2010Term Care Users. 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