Impacts of the COVID-19 Pandemic on the CODE ST-Segment Elevation Myocardial Infarction Program: A Quantitative and Qualitative Analysis

Background: The CODE ST-segment elevation myocardial infarction (STEMI) program is an operational standard of integrated service for STEMI patients carried out by Dr. Cipto Mangunkusumo Hospital. The emerging coronavirus disease 2019 (COVID-19) outbreak brought about many changes in the management...

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Main Authors: Eka Ginanjar, Arif Mansjoer, Lusiani Rusdi, Rizky Ramadantie, Hadiki Habib, Lies Dina Liastuti, Sally Aman Nasution, Idrus Alwi, Abdul Rashid
Format: Article
Language:English
Published: Interna Publishing 2024-04-01
Series:Acta Medica Indonesiana
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Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2591
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author Eka Ginanjar
Arif Mansjoer
Lusiani Rusdi
Rizky Ramadantie
Hadiki Habib
Lies Dina Liastuti
Sally Aman Nasution
Idrus Alwi
Abdul Rashid
author_facet Eka Ginanjar
Arif Mansjoer
Lusiani Rusdi
Rizky Ramadantie
Hadiki Habib
Lies Dina Liastuti
Sally Aman Nasution
Idrus Alwi
Abdul Rashid
author_sort Eka Ginanjar
collection DOAJ
description Background: The CODE ST-segment elevation myocardial infarction (STEMI) program is an operational standard of integrated service for STEMI patients carried out by Dr. Cipto Mangunkusumo Hospital. The emerging coronavirus disease 2019 (COVID-19) outbreak brought about many changes in the management of healthcare services, including the CODE STEMI program. This study aimed to evaluate the healthcare service quality of the CODE STEMI program during the COVID-19 pandemic based on the Donabedian concept.  Methods: This was a mixed-methods study using quantitative and qualitative analyses. It was conducted at the Dr. Cipto Mangunkusumo Hospital, a national referral hospital in Indonesia. We compared the data of each patient, including response time, clinical outcomes, length of stay, and cost, from a two-year period between 2018–2020 and 2020–2022 as the pre-COVID-19 CODE STEMI and COVID-19 CODE STEMI periods, respectively. Interviews were conducted to determine the quality of services from the perspectives of stakeholders. Results: A total of 195 patients participated in the study: 120 patients in pre-COVID-19 CODE STEMI and 75 patients in COVID-19 CODE STEMI. Our results showed that there was a significant increase in patient’s length of stay during the COVID-19 pandemic (4 days vs. 6 days, p < 0.001). Meanwhile, MACE (13% vs. 11%, p = 0.581), the in-hospital mortality rate (8% vs. 5%, p = 0.706), door-to-wire crossing time (161 min vs. 173 min, p = 0.065), door-to-needle time (151 min vs. 143 min p = 0.953), and hospitalization cost (3,490 USD vs. 3,700 USD, p = 0.945) showed no significant changes. In terms of patient satisfaction, patients found CODE STEMI during COVID-19 to be responsive and excellent. Conclusion: The implementation of the CODE STEMI program during the COVID-19 pandemic revealed that modified pathways were required because of the COVID-19 screening process. According to the Donabedian model, during the pandemic, the CODE STEMI program’s healthcare service quality decreased because of a reduction in efficacy, effectiveness, efficiency, and optimality. Despite these limitations attributed to the pandemic, the CODE STEMI program was able to provide good services for STEMI patients.
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spelling doaj-art-c065caccfe3d425e9f316e893e5585c32025-08-20T02:37:16ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322024-04-01561Impacts of the COVID-19 Pandemic on the CODE ST-Segment Elevation Myocardial Infarction Program: A Quantitative and Qualitative AnalysisEka Ginanjar0Arif Mansjoer1Lusiani Rusdi2Rizky Ramadantie3Hadiki Habib4Lies Dina Liastuti5Sally Aman Nasution6Idrus Alwi7Abdul Rashid81. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Integrated Cardiac Service Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.1. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Integrated Cardiac Service Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.1. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Integrated Cardiac Service Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Integrated Cardiac Service Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia1. Emergency Unit/Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Division of Respirology and Critical Care, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.1. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Integrated Cardiac Service Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.1. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Integrated Cardiac Service Unit, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.University of Cyber Jaya/An Nur Specialist Hospital, Bandar Baru Bangi, Selangor, Malaysia Background: The CODE ST-segment elevation myocardial infarction (STEMI) program is an operational standard of integrated service for STEMI patients carried out by Dr. Cipto Mangunkusumo Hospital. The emerging coronavirus disease 2019 (COVID-19) outbreak brought about many changes in the management of healthcare services, including the CODE STEMI program. This study aimed to evaluate the healthcare service quality of the CODE STEMI program during the COVID-19 pandemic based on the Donabedian concept.  Methods: This was a mixed-methods study using quantitative and qualitative analyses. It was conducted at the Dr. Cipto Mangunkusumo Hospital, a national referral hospital in Indonesia. We compared the data of each patient, including response time, clinical outcomes, length of stay, and cost, from a two-year period between 2018–2020 and 2020–2022 as the pre-COVID-19 CODE STEMI and COVID-19 CODE STEMI periods, respectively. Interviews were conducted to determine the quality of services from the perspectives of stakeholders. Results: A total of 195 patients participated in the study: 120 patients in pre-COVID-19 CODE STEMI and 75 patients in COVID-19 CODE STEMI. Our results showed that there was a significant increase in patient’s length of stay during the COVID-19 pandemic (4 days vs. 6 days, p < 0.001). Meanwhile, MACE (13% vs. 11%, p = 0.581), the in-hospital mortality rate (8% vs. 5%, p = 0.706), door-to-wire crossing time (161 min vs. 173 min, p = 0.065), door-to-needle time (151 min vs. 143 min p = 0.953), and hospitalization cost (3,490 USD vs. 3,700 USD, p = 0.945) showed no significant changes. In terms of patient satisfaction, patients found CODE STEMI during COVID-19 to be responsive and excellent. Conclusion: The implementation of the CODE STEMI program during the COVID-19 pandemic revealed that modified pathways were required because of the COVID-19 screening process. According to the Donabedian model, during the pandemic, the CODE STEMI program’s healthcare service quality decreased because of a reduction in efficacy, effectiveness, efficiency, and optimality. Despite these limitations attributed to the pandemic, the CODE STEMI program was able to provide good services for STEMI patients. http://www.actamedindones.org/index.php/ijim/article/view/2591COVID-19STEMICODE STEMIhealth care serviceDonabedian component
spellingShingle Eka Ginanjar
Arif Mansjoer
Lusiani Rusdi
Rizky Ramadantie
Hadiki Habib
Lies Dina Liastuti
Sally Aman Nasution
Idrus Alwi
Abdul Rashid
Impacts of the COVID-19 Pandemic on the CODE ST-Segment Elevation Myocardial Infarction Program: A Quantitative and Qualitative Analysis
Acta Medica Indonesiana
COVID-19
STEMI
CODE STEMI
health care service
Donabedian component
title Impacts of the COVID-19 Pandemic on the CODE ST-Segment Elevation Myocardial Infarction Program: A Quantitative and Qualitative Analysis
title_full Impacts of the COVID-19 Pandemic on the CODE ST-Segment Elevation Myocardial Infarction Program: A Quantitative and Qualitative Analysis
title_fullStr Impacts of the COVID-19 Pandemic on the CODE ST-Segment Elevation Myocardial Infarction Program: A Quantitative and Qualitative Analysis
title_full_unstemmed Impacts of the COVID-19 Pandemic on the CODE ST-Segment Elevation Myocardial Infarction Program: A Quantitative and Qualitative Analysis
title_short Impacts of the COVID-19 Pandemic on the CODE ST-Segment Elevation Myocardial Infarction Program: A Quantitative and Qualitative Analysis
title_sort impacts of the covid 19 pandemic on the code st segment elevation myocardial infarction program a quantitative and qualitative analysis
topic COVID-19
STEMI
CODE STEMI
health care service
Donabedian component
url http://www.actamedindones.org/index.php/ijim/article/view/2591
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