Background
Methods
Admission characteristics* | ||||
---|---|---|---|---|
period | 1996–2003 | |||
diagnosis | Myocardial infarction | Stroke | ||
agegroup | [35–74] | [75+] | [35–74] | [75+] |
Number of hospital admissions within LMR (before linking) | 151,104 | 60,853 | 104,222 | 85,098 |
Number of hospital admissions within linked LMR | 134,272 | 56,737 | 91,769 | 75,656 |
link yield (%) | 88.9 | 93.2 | 88.1 | 88.9 |
Index cases selected before application mortality restriction | 111,204 | 49,653 | 75,424 | 67,118 |
Index cases selected after application mortality restriction (death within a year of admission) | 13,662 | 19,328 | 16,089 | 31,304 |
Characteristics index-cases | ||||
Mean age | 60.4 | 81.0 | 63.1 | 81.7 |
Proportion male (%) | 74.5 | 49.9 | 60.7 | 41.8 |
Length of stay (days) | 8.3 | 9.6 | 14.8 | 21.6 |
Decrease length of stay 1996–2003 (%) | -10.2 | -7.2 | -29.6 | -30.4 |
General characteristics Dutch hospitals
†
| ||||
year | ||||
1996 | 2003 | |||
Number of hospitals (general, academic, categorical) | 148 | 129 | ||
Number of beds (clinical & day care) | 58,135 | 52,292 | ||
Number of clinical admissions (thousands) | 1,589 | 1,602 | ||
Number of clinical hospital days (thousands) | 15,531 | 12,757 | ||
Number of day care admissions (thousands)§
| 705 | 1,221 | ||
Workforce (full time equivalents, thousands) | 139 | 175 | ||
General characteristics Dutch population
†
| ||||
year | ||||
1996 | 2003 | |||
average population size ages 35–74 | 7.1 | 7.9 | ||
average population size ages 75+ | 0.9 | 1.0 | ||
persons treated in a hospital for cva (ICD9 430–434, 436–438] per 10,000 population‡
| 15.1 | 15.4 | ||
persons treated in a hospital for coronary heart disease [ICD9 410–414] per 10,000 population‡
| 45.4 | 39.8 |
-
deaths within the index-admission
-
deaths within a subsequent admission in the same hospital as the index-admission
-
deaths that occurred in a different hospital
-
deaths outside hospital
-
cause of death attributed to cause of index-admission
-
cause of death attributed to a circulation disorder other than index-condition
-
deaths due to other causes
Results
Deaths during initial admission | Deaths in same hospital. during subsequent admission | Deaths in a different hospital | Deaths outside hospital | All locations | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Time after admission | N | % | N | % | N | % | N | % | N | % |
Ages 35–74
| ||||||||||
deaths in 0–29 days
| * | * | ||||||||
1996–1997
| 2,257 | 86.8 | 68 | 2.6 | 153 | 5.9 | 123 | 4.7 | 2,601 | 100.0 |
1998–1999
| 1,967 | 82.1 | 69 | 2.9 | 207 | 8.6 | 153 | 6.4 | 2,396 | 100.0 |
2000–2001
| 1,793 | 79.9 | 81 | 3.6 | 242 | 10.8 | 128 | 5.7 | 2,244 | 100.0 |
2002–2003
| 1,627 | 79.7 | 75 | 3.7 | 223 | 10.9 | 116 | 5.7 | 2,041 | 100.0 |
deaths in 30–89 days
|
†
| |||||||||
1996–1997
| 47 | 10.5 | 121 | 27.0 | 65 | 14.5 | 215 | 48.0 | 448 | 100.0 |
1998–1999
| 50 | 14.6 | 110 | 32.2 | 44 | 12.9 | 138 | 40.4 | 342 | 100.0 |
2000–2001
| 42 | 12.5 | 99 | 29.4 | 63 | 18.7 | 133 | 39.5 | 337 | 100.0 |
2002–2003
| 37 | 11.2 | 115 | 34.8 | 65 | 19.7 | 113 | 34.2 | 330 | 100.0 |
deaths in 90–364 days
| ||||||||||
1996–1997
| 4 | 0.4 | 317 | 35.3 | 137 | 15.3 | 439 | 48.9 | 897 | 100.0 |
1998–1999
| 3 | 0.4 | 242 | 33.1 | 110 | 15.0 | 376 | 51.4 | 731 | 100.0 |
2000–2001
| 3 | 0.4 | 247 | 35.2 | 113 | 16.1 | 338 | 48.2 | 701 | 100.0 |
2002–2003
| 5 | 0.8 | 203 | 34.2 | 94 | 15.8 | 292 | 49.2 | 594 | 100.0 |
Ages 75+
| ||||||||||
deaths in 0–29 days
| * |
†
| * |
†
| ||||||
1996–1997
| 2,956 | 89.3 | 79 | 2.4 | 87 | 2.6 | 188 | 5.7 | 3,310 | 100.0 |
1998–1999
| 2,869 | 88.5 | 92 | 2.8 | 102 | 3.1 | 178 | 5.5 | 3,241 | 100.0 |
2000–2001
| 2,674 | 86.4 | 118 | 3.8 | 130 | 4.2 | 173 | 5.6 | 3,095 | 100.0 |
2002–2003
| 2,618 | 83.7 | 119 | 3.8 | 168 | 5.4 | 222 | 7.1 | 3,127 | 100.0 |
deaths in 30–89 days
| ||||||||||
1996–1997
| 80 | 14.2 | 173 | 30.7 | 45 | 8.0 | 265 | 47.1 | 563 | 100.0 |
1998–1999
| 73 | 12.6 | 170 | 29.3 | 66 | 11.4 | 271 | 46.7 | 580 | 100.0 |
2000–2001
| 88 | 15.8 | 161 | 28.9 | 61 | 11.0 | 247 | 44.3 | 557 | 100.0 |
2002–2003
| 69 | 12.2 | 161 | 28.4 | 49 | 8.7 | 287 | 50.7 | 566 | 100.0 |
deaths in 90–364 days
| ||||||||||
1996–1997
| 5 | 0.5 | 368 | 33.8 | 103 | 9.5 | 613 | 56.3 | 1,089 | 100.0 |
1998–1999
| 9 | 0.9 | 330 | 31.8 | 114 | 11.0 | 584 | 56.3 | 1,037 | 100.0 |
2000–2001
| 8 | 0.8 | 329 | 31.2 | 96 | 9.1 | 620 | 58.9 | 1,053 | 100.0 |
2002–2003
| 7 | 0.6 | 377 | 34.0 | 88 | 7.9 | 638 | 57.5 | 1,110 | 100.0 |
Deaths during initial admission | Deaths in same hospital, during subsequent admission | Deaths in a different hospital | Deaths outside hospital | All locations | ||||||
---|---|---|---|---|---|---|---|---|---|---|
Time after admission | N | % | N | % | N | % | N | % | N | % |
Ages 35–74
| ||||||||||
deaths in 0–29 days
|
†
|
†
| ||||||||
1996–1997
| 2,609 | 94.0 | 31 | 1.1 | 80 | 2.9 | 56 | 2.0 | 2,776 | 100.0 |
1998–1999
| 2,555 | 94.2 | 32 | 1.2 | 77 | 2.8 | 49 | 1.8 | 2,713 | 100.0 |
2000–2001
| 2,520 | 93.3 | 28 | 1.0 | 93 | 3.4 | 60 | 2.2 | 2,701 | 100.0 |
2002–2003
| 2,463 | 91.8 | 46 | 1.7 | 86 | 3.2 | 87 | 3.2 | 2,682 | 100.0 |
deaths in 30–89 days
| * | * | ||||||||
1996–1997
| 238 | 44.8 | 94 | 17.7 | 36 | 6.8 | 163 | 30.7 | 531 | 100.0 |
1998–1999
| 192 | 42.0 | 92 | 20.1 | 26 | 5.7 | 147 | 32.2 | 457 | 100.0 |
2000–2001
| 162 | 35.8 | 77 | 17.0 | 35 | 7.7 | 178 | 39.4 | 452 | 100.0 |
2002–2003
| 124 | 26.1 | 99 | 20.8 | 31 | 6.5 | 222 | 46.6 | 476 | 100.0 |
deaths in 90–364 days
| * |
†
|
†
|
†
| ||||||
1996–1997
| 38 | 4.3 | 271 | 30.7 | 67 | 7.6 | 506 | 57.4 | 882 | 100.0 |
1998–1999
| 46 | 5.3 | 243 | 28.2 | 82 | 9.5 | 490 | 56.9 | 861 | 100.0 |
2000–2001
| 37 | 4.8 | 189 | 24.5 | 79 | 10.2 | 467 | 60.5 | 772 | 100.0 |
2002–2003
| 10 | 1.3 | 194 | 24.7 | 67 | 8.5 | 515 | 65.5 | 786 | 100.0 |
Ages 75+
| ||||||||||
deaths in 0–29 days
| * | * | ||||||||
1996–1997
| 4,239 | 94.7 | 28 | 0.6 | 42 | 0.9 | 168 | 3.8 | 4,477 | 100.0 |
1998–1999
| 4,375 | 94.7 | 30 | 0.6 | 53 | 1.1 | 161 | 3.5 | 4,619 | 100.0 |
2000–2001
| 4,526 | 93.5 | 43 | 0.9 | 74 | 1.5 | 198 | 4.1 | 4,841 | 100.0 |
2002–2003
| 4,453 | 90.4 | 59 | 1.2 | 74 | 1.5 | 342 | 6.9 | 4,928 | 100.0 |
deaths in 30–89 days
| * |
†
| * | |||||||
1996–1997
| 668 | 52.5 | 97 | 7.6 | 19 | 1.5 | 488 | 38.4 | 1,272 | 100.0 |
1998–1999
| 629 | 50.2 | 102 | 8.1 | 42 | 3.3 | 481 | 38.4 | 1,254 | 100.0 |
2000–2001
| 641 | 49.1 | 115 | 8.8 | 49 | 3.8 | 501 | 38.4 | 1,306 | 100.0 |
2002–2003
| 413 | 29.1 | 143 | 10.1 | 28 | 2.0 | 836 | 58.9 | 1,420 | 100.0 |
deaths in 90–364 days
| * | * | ||||||||
1996–1997
| 105 | 6.0 | 266 | 15.1 | 60 | 3.4 | 1,328 | 75.5 | 1,759 | 100.0 |
1998–1999
| 184 | 10.4 | 274 | 15.4 | 81 | 4.6 | 1,235 | 69.6 | 1,774 | 100.0 |
2000–2001
| 122 | 6.7 | 274 | 15.1 | 74 | 4.1 | 1,350 | 74.2 | 1,820 | 100.0 |
2002–2003
| 37 | 2.0 | 289 | 15.8 | 63 | 3.4 | 1,445 | 78.8 | 1,834 | 100.0 |
Deaths due to AMI [I21-I22] | Deaths due to other circulatory disorders | Deaths due to other causes | all causes | |||||
---|---|---|---|---|---|---|---|---|
Time after admission | N | % | N | % | N | % | N | % |
Ages 35+
| ||||||||
deaths in 0–29 days
| * | * | * | |||||
1996–1997
| 4,533 | 76.7 | 834 | 14.1 | 544 | 9.2 | 5,911 | 100.0 |
1998–1999
| 4,219 | 74.8 | 863 | 15.3 | 555 | 9.8 | 5,637 | 100.0 |
2000–2001
| 3,839 | 71.9 | 865 | 16.2 | 635 | 11.9 | 5,339 | 100.0 |
2002–2003
| 3,632 | 70.3 | 900 | 17.4 | 636 | 12.3 | 5,168 | 100.0 |
deaths in 30–89 days
| * |
†
| ||||||
1996–1997
| 392 | 38.8 | 385 | 38.1 | 234 | 23.1 | 1,011 | 100.0 |
1998–1999
| 323 | 35.0 | 384 | 41.6 | 215 | 23.3 | 922 | 100.0 |
2000–2001
| 310 | 34.7 | 350 | 39.1 | 234 | 26.2 | 894 | 100.0 |
2002–2003
| 263 | 29.4 | 377 | 42.1 | 256 | 28.6 | 896 | 100.0 |
deaths in 90–364 days
| * | * | ||||||
1996–1997
| 541 | 27.2 | 804 | 40.5 | 641 | 32.3 | 1,986 | 100.0 |
1998–1999
| 444 | 25.1 | 743 | 42.0 | 581 | 32.9 | 1,768 | 100.0 |
2000–2001
| 394 | 22.5 | 697 | 39.7 | 663 | 37.8 | 1,754 | 100.0 |
2002–2003
| 326 | 19.1 | 720 | 42.3 | 658 | 38.6 | 1,704 | 100.0 |
Deaths due to cva [I61-I69] excl. subarachnoid hemorrhage | Deaths due to other circulatory disorders | Deaths due to other causes | all causes | |||||
---|---|---|---|---|---|---|---|---|
Time after admission | N | % | N | % | N | % | N | % |
Ages 35+
| ||||||||
deaths in 0–29 days
| ||||||||
1996–1997
| 5,395 | 74.4 | 898 | 12.4 | 960 | 13.2 | 7,253 | 100.0 |
1998–1999
| 5,459 | 74.5 | 823 | 11.2 | 1,050 | 14.3 | 7,332 | 100.0 |
2000–2001
| 5,651 | 74.9 | 838 | 11.1 | 1,053 | 14.0 | 7,542 | 100.0 |
2002–2003
| 5,717 | 75.1 | 878 | 11.5 | 1,015 | 13.3 | 7,610 | 100.0 |
deaths in 30–89 days
|
†
| |||||||
1996–1997
| 1,070 | 59.3 | 270 | 15.0 | 463 | 25.7 | 1,803 | 100.0 |
1998–1999
| 989 | 57.8 | 265 | 15.5 | 457 | 26.7 | 1,711 | 100.0 |
2000–2001
| 1,012 | 57.6 | 281 | 16.0 | 465 | 26.5 | 1,758 | 100.0 |
2002–2003
| 1,036 | 54.6 | 311 | 16.4 | 549 | 29.0 | 1,896 | 100.0 |
deaths in 90–364 days
|
†
|
†
| ||||||
1996–1997
| 1,044 | 39.5 | 563 | 21.3 | 1,034 | 39.2 | 2,641 | 100.0 |
1998–1999
| 1,064 | 40.4 | 513 | 19.5 | 1,058 | 40.2 | 2,635 | 100.0 |
2000–2001
| 1,024 | 39.5 | 514 | 19.8 | 1,054 | 40.7 | 2,592 | 100.0 |
2002–2003
| 931 | 35.5 | 529 | 20.2 | 1,160 | 44.3 | 2,620 | 100.0 |
30- day mortality initial admission | 30- day mortality initial + subsequent admissions | 30-day mortality all locations of death | 90- day mortality initial + subsequent admissions | 90-day mortality all locations of death | 365- day mortality initial + subsequent admissions | 365-day mortality all locations of death | |
---|---|---|---|---|---|---|---|
a) mortality rates ages 35–74 | |||||||
1996–1997
| 7.1 | 7.7 | 8.1 | 8.3 | 9.3 | 9.5 | 11.5 |
1998–1999
| 6.6 | 7.6 | 8.0 | 8.3 | 9.1 | 9.4 | 11.2 |
2000–2001
| 6.5 | 7.6 | 8.0 | 8.3 | 9.0 | 9.4 | 11.2 |
2002–2003
| 5.8 | 6.9 | 7.3 | 7.6 | 8.3 | 8.6 | 10.3 |
difference 2003–1996
| -1.3 | -0.9 | -0.8 | -0.8 | -0.9 | -0.9 | -1.2 |
b) mortality rates ages 75+
| |||||||
1996–1997
| 24.2 | 25.6 | 27.1 | 28.1 | 31.8 | 31.8 | 40.5 |
1998–1999
| 23.3 | 24.9 | 26.3 | 27.4 | 31.0 | 31.0 | 39.2 |
2000–2001
| 21.7 | 23.7 | 25.1 | 26.3 | 29.6 | 29.7 | 38.1 |
2002–2003
| 20.2 | 22.4 | 24.1 | 24.5 | 28.4 | 28.1 | 36.8 |
difference 2003–1996
| -4.1 | -3.2 | -3.1 | -3.6 | -3.4 | -3.8 | -3.7 |
30- day mortality initial admission | 30- day mortality initial + subsequent admissions | 30-day mortality all locations of death | 90- day mortality initial + subsequent admissions | 90-day mortality all locations of death | 365- day mortality initial + subsequent admissions | 365-day mortality all locations of death | |
---|---|---|---|---|---|---|---|
a) mortality rates ages 35–74 | |||||||
1996–1997
| 12.3 | 13.0 | 13.3 | 14.5 | 15.4 | 16.1 | 18.8 |
1998–1999
| 12.5 | 13.2 | 13.4 | 14.4 | 15.3 | 15.9 | 18.7 |
2000–2001
| 12.5 | 13.2 | 13.4 | 14.2 | 15.2 | 15.5 | 18.4 |
2002–2003
| 11.4 | 12.1 | 12.4 | 13.1 | 14.3 | 14.2 | 17.3 |
difference 2003–1996
| -0.9 | -0.9 | -0.9 | -1.4 | -1.1 | -1.9 | -1.5 |
b) mortality rates ages 75+
| |||||||
1996–1997
| 26.5 | 26.9 | 27.9 | 31.8 | 35.8 | 34.5 | 46.8 |
1998–1999
| 26.5 | 27.0 | 27.9 | 31.7 | 35.5 | 35.0 | 46.3 |
2000–2001
| 26.3 | 26.9 | 28.0 | 31.6 | 35.5 | 34.4 | 46.1 |
2002–2003
| 23.5 | 24.2 | 26.0 | 27.3 | 33.4 | 29.4 | 43.0 |
difference 2003–1996
| -3.0 | -2.7 | -2.0 | -4.5 | -2.5 | -5.1 | -3.8 |