"In terms of both quantity and trend, the construction of chest pain centers has shifted from early steady exploration to mature, large-scale development. It is noteworthy that although populous provinces have a relatively high number of certified chest pain centers, the construction quantity per million population is still insufficient due to population density." Recently, Professor Xiang Dingcheng from the General Hospital of the Southern Theater Command of the People's Liberation Army pointed out in an interview that there is still significant room for development if the goal of establishing chest pain centers in secondary and above medical institutions nationwide is to be achieved.
In a presentation by Xiang Dingcheng:
Data statistics reveal that Chest Pain Centers have treated over 14.67 million chest pain patients. The in-hospital mortality rate for ST-segment elevation myocardial infarction (STEMI) patients nationwide was 10.1% in 2011. However, the quality control report from Chest Pain Centers in 2023 showed an average in-hospital mortality rate of 3.4%, marking a significant 65% decrease. Over the three-year period from 2018 to 2020, urban areas witnessed a declining trend in acute myocardial infarction mortality, with a decrease of 2 deaths per 100,000 population, while rural areas remained stable at 78 deaths per 100,000 population, indicating an overall turning point in the mortality rate of myocardial infarction patients.
Apart from the decline in mortality rates, economic indicators also show a downward trend in the average length of hospital stay and average hospitalization costs for STEMI patients at Chest Pain Centers. In 2023, the standard and grassroots versions of Chest Pain Centers recorded average hospital stays of 7.8 days and 6.6 days, respectively, with average hospitalization costs of ¥27,400 and ¥17,600.
"However, there is still room for improvement in the treatment of aortic dissection and pulmonary embolism," according to the data provided by Xiang Dingcheng. Treatment strategies for aortic dissection mainly consist of conservative treatment (42%), followed by surgical procedures (23%), elective intervention (18%), and emergency intervention (6%). The proportion of pulmonary embolism patients receiving anticoagulant therapy is 56%, while 74% are screened as suitable for thrombolytic therapy.
To address these issues, adjustments have been made to the organizational framework of national Chest Pain Center construction in 2023. The National Center for Radiology and Treatment Clinical Medical Research will now oversee this, with the establishment of a National Chest Pain Center Expert Committee and the creation of coordinating organizational structures and expert systems. This will closely align with national policy directions to enhance the essence of Chest Pain Center construction. Furthermore, there will be a focus on strengthening clinical specialty capacity assessments, centered around patients, continuously enhancing the medical service capabilities, medical technology capabilities, medical quality and safety levels, and medical service efficiency of relevant clinical specialties. Simultaneously, there will be an active response to the call for the construction of closely-knit county-level medical communities, systematically reshaping the medical and health system and integrating and optimizing medical and health resources to enhance grassroots medical and health service capabilities, ensuring that the public has access to fair and accessible high-quality medical services.
Finally, Xiang Dingcheng particularly emphasized that quality control is one of the key focuses for the future development of Chest Pain Centers. The overall approach to the high-quality development of Chest Pain Centers 2.0 is to accelerate comprehensive coverage, accelerate the extension of critical and full processes, and accelerate the development of intelligent technology. The future development direction of Chest Pain Centers will focus on ensuring the quality of treatment, implementing normalized quality control, innovating recertification processes, exploring the establishment of recertification mechanisms based on external quality control, deepening system construction, vigorously promoting the construction of chest pain treatment units, strengthening the cardiovascular disease full-process management system, exploring cardiovascular critical illness treatment models, enhancing specialty treatment capabilities, accelerating the construction of intelligent chest pain centers, empowering treatment processes with informatization, promoting the construction of Chest Pain Centers in Hong Kong and Macao, continuously conducting public training and education to enhance effectiveness, and promoting the development of single-disease cardiovascular disease management centers.
