Effects of national hospital accreditation in acute coronary syndrome on in-hospital mortality and clinical outcomes

Ta Ko, Chia Hung Yang, Chun Tai Mao, Li Tang Kuo, Ming Jer Hsieh, Dong Yi Chen, Chao Yung Wang, Yu Sheng Lin, I. Chang Hsieh, Shao Wei Chen, Ming Jui Hung, Wen Jin Cherng, Tien Hsing Chen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations


Background: Acute coronary syndrome (ACS) is a life-threatening medical condition that accounts for an annual expenditure of more than $300 billion in the United States. Hospital accreditation has been shown to improve patient and hospital outcomes for various conditions. Objectives: This study aimed to determine the benefits of hospital accreditation in patients with ACS. Methods: This nationwide population-based cohort study used Taiwan’s National Health Insurance Research Database from 1997 to 2011 (n = 249,354). Multivariable logistic regression was used to analyze the risk of inhospital events among those treated in accredited and non-accredited hospitals, and to compare outcomes in hospitals before and after accreditation. The effect of accreditation on these events was also stratified by accreditation grade. Results: A total of 823 hospitals were included, of which 2.4% were medical centers, 13.7% were regional hospitals, and 83.8% were district hospitals. The in-hospital mortality [odds ratio (OR), 0.82; 95% confidence interval (CI), 0.79-0.85; p < 0.001] and recurrent acute myocardial infarction (AMI) admission (OR, 0.81; 95% CI, 0.71-0.93; p = 0.003) rates were significantly lower in the after-accreditation group than in the before-accreditation group. There was a substantial and marked decrease in the in-hospital mortality rate after accreditation in 2008. Conclusions: This cohort study demonstrated that ACS accreditation was associated with better in-hospital mortality and recurrent AMI admission rates in ACS patients.

Original languageEnglish
Pages (from-to)416-427
Number of pages12
JournalActa Cardiologica Sinica
Issue number5
StatePublished - 2020

Bibliographical note

Publisher Copyright:
© 2020, Republic of China Society of Cardiology. All rights reserved.


  • Acute coronary syndrome
  • Hospital accreditation
  • In-hospital mortality


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