Table 2.
Results from segmented Linear Regression Models for Each Outcome for All Patients and Stratified by Admission to Internal Medicine Versus other Services
| Parameter estimate (95 % CI) | All services | Internal medicine services* | Other services† |
|---|---|---|---|
| Guideline concordant cardiac biomarker ordering | |||
| Level in January 2009 | 57.1 % (56.4 % to 57.8 %) | 23.0 % (21.6 % to 24.3 %) | 87.8 % (87.5 % to 88.2 %) |
| Baseline trend | N/A (p > 0.20) | 0.1 % per month (0.0 % to 0.2 %) | N/A (p > 0.20) |
| Post-intervention level change | 34.0 % (31.9 % to 36.0 %) | 60.0 % (57.3 % to 62.7 %) | 9.1 % (8.4 % to 9.7 %) |
| Post-intervention trend change | 0.4 % per month (0.1 % to 0.6 %) | 0.4 % per month (0.1 % to 0.7 %) | N/A (p > 0.20) |
| Troponin tests ordered per patient | |||
| Level in January 2009 | 1.33 (1.30 to 1.36) | 2.39 (2.34 to 2.45) | 0.32 (0.30 to 0.34) |
| Baseline trend | −0.006 per month (−0.004 to −0.008) | −0.01 per month (−0.02 to −0.01) | −0.001 per month (−0.002 to −0.000) |
| Post-intervention level change | −0.20 (−0.25 to −0.15) | −0.39 (−0.50 to −0.28) | −0.05 (−0.08 to −0.02) |
| Post-intervention trend change | N/A (p > 0.20) | 0.009 per month (−0.003 to 0.021) | N/A (p > 0.20) |
| CK-MB tests ordered per patient | |||
| Level in January 2009 | 1.41 (1.38 to 1.44) | 2.56 (2.51 to 2.61) | 0.31 (0.29 to 0.33) |
| Baseline trend | −0.01 per month (−0.01 to −0.01) | −0.02 per month (−0.02 to −0.02) | −0.002 per month (−0.003 to −0.001) |
| Post-intervention level change | −0.96 (−1.01 to −0.91) | −1.76 (−1.86 to −1.66) | −0.21 (−0.24 to −0.17) |
| Post-intervention trend change | N/A (p > 0.20) | 0.01 per month (−0.00 to 0.02) | N/A (p > 0.20) |
| Primary diagnosis of ACS | |||
| Level in January 2009 | 1.14 % (1.01 % to 1.28 %) | 2.34 % (2.06 % to 2.61 %) | 0.007 % (−0.006 % to 0.020 %) |
| Baseline trend | −0.005 % per month (−0.0012 % to 0.002 %) |
−0.011 % per month (−0.026 % to 0.004 %) | N/A (p > 0.20) |
| Post-intervention level change | 0.25 % (0.03 % to 0.47 % | 0.49 % per month (0.04 % to 0.95 %) | N/A (p > 0.20) |
| Post-intervention trend change | N/A (p > 0.20) | N/A (p > 0.20) | 0.005 % per month (0.001 % to 0.008 %) |
* Internal medicine services included general medicine, cardiology, pulmonary, and renal
† Other services included general surgery, orthopedics, gynecology, obstetrics, psychiatry, neurology, neurosurgery, urology, vascular surgery, trauma, otolaryngology, burn surgery, plastic surgery, chemical dependency