Study looks at heart attack and acute angina patients in China

A survey of heart attack and acute angina patients in China has revealed that in many cases treatment is determined by financial considerations, not by the patients' potential for clinical benefit.

The survey was carried out by the George Institute for International Health between September 2004 and May 2005, when data was collected from nearly 3000 patients admitted to 51 hospitals in 18 provinces in China.

Professor Anushka Patel, director of the cardiovascular division of the George Institute and a senior lecturer at the University of Sydney, said: "The results showed that many more expensive treatments that are used to treat patients with heart attack, suspected heart attack or severe angina were not being given to those at highest risk but were often used for patients at lower risk who probably wouldn't benefit from those treatments."

The study also found inconsistencies between doctor-assigned diagnoses and objective measures in up to 20 per cent of cases.

Similar surveys in European and North American hospitals have found similar results.

The study, recently published online in the international Heart BMJ Journal, will be used as baseline data for the next intervention phase of the study. Launched this month, this new four year study will involve 70 Chinese hospitals and around 18,000 patients.

One of the aims of the George Institute, a Sydney-based not-for-profit research institute affiliated with Sydney University, is to help China improve its health care system. The institute opened a new research office in Beijing in May, which is running the second phase of the study.

The director of the China branch, Professor Wu Yangfeng, said the study would address the challenge of providing evidence-based care for acute coronary syndrome (ACS) patients in a cost-effective way.

"We are promoting the use of clinical standards in the diagnosis and the treatment of ACS patients in Chinese hospitals. We hope that by doing this we can help Chinese hospitals improve the quality of their medical care for ACS patients," Professor Wu said.

The George Institute's Chinese office has worked closely with Chinese cardiologists to ensure that phase two of the study will specifically address the challenges faced in the Chinese health care system and will be effective in improving patient care.

A similar model has already been successfully tested in North American hospitals.

Chinese experts involved in the study include Professor Gao Runlin, president of the Chinese Society of Cardiology and co-principal investigator of the CPACS study, members of the Peking University Health Science Centre, and the China Ministry of Health.

The study was jointly developed by the Chinese Society of Cardiology and the George Institute.

Coronary heart disease is a leading cause of premature death in China and is increasingly a leading cause of death worldwide.

The George Institute's Beijing branch is currently working in collaboration with more than 200 hospitals, medical universities and research institutes in China.