Hospital volume and outcomes for inpatients with acute myocardial infarction in Shanxi, China: A cross-sectional study.

In this cross-sectional study, we assessed the relationship between hospital volume and clinical outcomes for inpatients with acute myocardial infarction (AMI) in tertiary A hospitals in Shanxi, China (N = 12 931). In-hospital mortality, length of stay (LOS), and total cost were measured. The crude in-hospital mortality rate was 1.69%. Adjusted in-hospital mortality was significantly lower for medium-volume hospitals (odds ratio (OR) = 0.605, 95% confidence interval (CI) = 0.411-0.900) compared with low-volume hospitals. LOS in medium- and high-volume hospitals were 0.915 (95% CI = 0.880-0.951) and 1.069 (95% CI = 1.041-1.098) days longer than in low-volume hospitals, respectively. The cost of inpatients attending low- and high-volume hospitals (OR = 1.180, 95% CI = 1.140-1.221) was higher than that of medium-volume hospitals (OR = 0.897, 95% CI = 0.868-0.926). These results inform health care policy in countries with strained medical resources.