IJCS | Volume 31, Nº4, July / August 2018

342 Oliveira et al VICTIM Registry Int J Cardiovasc Sci. 2018;31(4)339-358 Original Article Table 1 - Characteristics of the hospitals participating in the VICTIM Registry Characteristics of the hospitals Public hospital patients N (370*) Private hospital patients N (82*) Hospital 1 (370*) Hospital 2 (35*) Hospital 3 (17*) Hospital 4 (30*) Location Capital Capital Capital Capital Type Non-profit-making Profit-making Profit-making Profit-making Total number of beds 279 208 147 49 COU beds 10 10 0 8 General hospital YES YES YES NO Access as user of SUS YES NO NO NO Ability to perform PCI YES YES YES YES Ability to perform heart surgery YES YES YES YES Patients admitted via direct access* 6 (1.5%) 27 (77%) 15 (88%) 12 (40%) Patients admitted via referral* 364 (98.5%) 8 (23%) 2 (12%) 18 (60%) N: Number of patients; COU: Coronary Unit; SUS: Brazilian Unified Health System; PCI: Percutaneous Coronary Intervention; (*) Period: December 2014 to April 2016. The private hospitals, however, provide care to a heterogeneous population, comprising patients with different health insurance plans and those who choose to pay for their own healthcare. Each of the three private hospitals has its specific set of health insurance plans, which makes their population heterogeneous. Such hospitals have direct entrance to their emergency units, thus, the patient can have direct access to those hospitals or can be referred from another health institution. In the state of Sergipe, 80.7% of the population has no health insurance, relying, therefore, on the SUS, depending consequently on one single hospital as reference for the treatment of STEMI. The other 19.3% of the population has health insurance, counting on three hospitals with catheterization laboratory. Because of the lack of the necessary responsiveness in the SUS, some patients, even with neither health insurance nor a favorable economic condition, opt for the private service care. 19 Except for those four hospitals, no other hospital of the Sergipe healthcare systemhas a team of cardiologists on call or a clinical team capable of identifying and treating patients with STEMI, especially regarding the prescription of thrombolytic agents or the infrastructure to perform primary angioplasty. The basic assumption is that the care provided to patients with STEMI in the four cardiovascular referral hospitals has the best quality in the state (Figure 2). Thus, to compare the quality of the care provided to users of the SUS with that provided at the three private hospitals will reflect the best public and private healthcare provided in the state of Sergipe. Eligibility of the patients Patients with the following characteristics are considered eligible for the VICTIM Registry: both sexes; older than 18 years; clinical findings compatible with acute coronary syndrome and electrocardiogram (ECG) showing persistent ST-segment elevation > 1 mm on two contiguous leads; 7,8 and who provide written informed consent. The diagnosis of AMI is confirmed later, based on the classical changes of the biomarkers CK-MB and/or troponin, 7,8 taking into consideration the final opinion of the medical team.