Acute myocardial infarction (AMI) accounts for approximately one-third of all deaths in subjects over 35 years old, and in Colombia, it ranks among the top five causes of mortality (2020-2021). The Acute Myocardial Infarction Center of Excellence (AMICE) is a health program of the Cardiovascular Foundation of Colombia (FCV), certified by the Joint Commission International, which works with criteria of excellence, technological innovation, and a high social sense to provide users with the best health care and experience. The AMICE is made up of a group of specialized human talent in cardiology, hemodynamics, psychology, nutrition, social work, physiotherapy, and nursing, who work together to treat the patient in all their biopsychosocial spheres. Likewise, it provides in-hospital education to empower patients in their pathology and facilitate decision-making regarding treatment options, using tools such as booklets and education workshops. It also provides in-person and telephone follow-up during the first year after the event to reduce rehospitalizations and reinforce education. Additionally, patient experience surveys show 99% satisfaction among users.
This program is supported by technological tools such as REDCap for the AMICE’s database records and Power BI for the dashboards that show attendance and administrative indicators, facilitating decision-making. All of this is aimed at improving the health status of patients with AMI every day.
This program is supported by technological tools such as REDCap for the AMICE’s database records and Power BI for the dashboards that show attendance and administrative indicators, facilitating decision-making. All of this is aimed at improving the health status of patients with AMI every day.
The FCV has various forms of contracting with the health insurances including Prospective Global Payment (PGP), which allows for early portfolio return to health institutions and advance resource scheduling.
The following are the AMICE’s results:
• In the last two years, the cases handled by the AMICE increased by 34% (2021=575 discharges patients and 2022=770), providing greater opportunities for quality care to the population of northeastern Colombia.
• Average hospital stay was 16% lower for PGP-contracted patients compared to other contracts (5.97 vs. 7.09 p=0.0072).
• Readmissions within the first 30 days after discharge were 28% less in PGP (43 patients per 1000 for the PGP group and 55 per 1000 for users of other contracts).
• In-hospital mortality of patients treated by the AMICE with PGP was 4.17% and 3.95% in non-PGP (no statistically significant difference p=0.87), which is < 4%, lower than international standards.
• The costs of treating CEIAM patients were 9.35% lower in those whose contract was through PGP (€ 2.963,09 PGP and € 3.268,69 Non PGP, p=0,038).
• Payment by the insurer to the institution was 30 days on average for PGP compared to 147 days with other contract types.
These achievements support the PGP model by demonstrating good clinical outcomes at a lower cost and shows that the AMICE provides a service with excellent treatments that guarantee better morbidity and mortality outcomes than international benchmarks.