Improving outcomes for acute coronary syndrome in the Russian Federation: an example of regionalization of services for improved quality and systems of care for acute coronary syndrome in Saint Petersburg: good practice brief

ABSTRACT

Within the framework of the Federal Cardiovascular Programme, services for acute coronary syndrome (ACS) were transformed over a decade in St Petersburg. It was motivated by a relatively high cardiovascular mortality, high in-hospital mortality from ACS, low availability of modern technologies, low adherence to guidelines, insufficient quality of care and insufficient funding. A comprehensive regionalization of services led to high availability of care, efficacy in ambulance routing, a high degree of implementation of the model of care, increased access to reperfusion technologies, improved adherence to guidelines and improved quality of care. It was associated with a decrease of in-hospital mortality from ACS and a decrease in cardiovascular mortality.