Cent Eur J Public Health 2025, 33(1):49-56 | DOI: 10.21101/cejph.a8462

The role of conservative treatment in regional variations of 30-day acute myocardial infarction mortality: a case of the Czech Republic

Ivo Hlaváč1, Matěj Opatrný2
1 Department of Epidemiology and Public Health, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
2 Institute of Economic Studies, Faculty of Social Sciences, Charles University, Prague, Czech Republic

Objectives: The aim of the study was to analyse the role of conservative treatment and regional differences in 30-day hospital mortality for acute myocardial infarction (AMI) patients in the Czech Republic.

Methods: Using administrative data from Czech health insurance companies for 2018-2020, we employed a probit model to examine factors influencing mortality across 13 complex cardiovascular centres, calculating average marginal effects to ensure interpretable results.

Results: Conservative treatment was associated with a 4.7 percentage point increase in 30-day mortality compared to percutaneous coronary intervention (PCI) treatment (95% CI: 3.6-5.7). This effect varied significantly across different types of AMI and healthcare providers, with regional variations in mortality ranging from 0 to 4.3 percentage points relative to the best-performing centre.

Conclusions: Higher proportions of conservative treatment significantly contribute to increased 30-day mortality in complex cardiovascular centres. The persistent regional variations after controlling for patient characteristics suggest the need for standardized treatment protocols and improved data collection systems to reduce disparities in outcomes.

Keywords: acute myocardial infarction, conservative treatment, regional variation, mortality, probit model

Received: November 11, 2024; Revised: March 25, 2025; Accepted: March 25, 2025; Published: March 31, 2025  Show citation

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Hlaváč I, Opatrný M. The role of conservative treatment in regional variations of 30-day acute myocardial infarction mortality: a case of the Czech Republic. Cent Eur J Public Health. 2025;33(1):49-56. doi: 10.21101/cejph.a8462.
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