HeartRescue focuses on working with healthcare partners in select districts in Shanghai, and the city of Suzhou, drawing upon lessons learned and expertise from the HeartRescue Project currently operating in the United States, and starting in Bangalore, India.
Community Assessments: HeartRescue China is working with local partners to conduct needs assessments in each district to identify access-related barriers, service delivery gaps, community requirements, and opportunities within the acute health systems.
Demonstration Projects: With results from the community assessments, HeartRescue China will engage multi-sector stakeholders to guide the program and to contribute to the design and execution of demonstration projects. These projects will focus on community-based interventions that leverage best practices and opportunities to integrate with existing health programs, and supporting related policy.
Management, Measurement and Collaboration: During the implementation of the demonstration projects, HeartRescue China will manage and monitor the performance of the local initiatives to build capacity and provide technical assistance as needed. HeartRescue China will also facilitate routine information-sharing and peer-to-peer learning among the partners and local stakeholders by convening technical fora and other events.
Evaluation: At the completion of the demonstration projects, HeartRescue China will conduct evaluations in the targeted geographies to assess the impact of the program. It is expected that the emerging best practices and lessons learned will guide future acute CV systems of care in China and beyond.
PartnersResearch Triangle Institute (RTI) International
RTI will coordinate HeartRescue global and country-level programs. RTI International is one of the world’s leading research institutes, dedicated to improving the human condition by turning knowledge into practice.The Institute for Health Metrics and Evaluation (IHME)
IHME will drive HeartRescue monitoring and evaluation. IHME is an independent global health research organization at the University of Washington that provides rigorous and comparable measurement of the world’s most important health problems.Shanghai Jiao Tong University (SJTU) School of Medicine
SJTU School of Medicine will coordinate the program implementation in Shanghai. SJTU Medicine is a top-ranked medical research and education institute in China with its strong academic and clinical programs including 14 affiliated hospitals and 10 academic programs including the school of public health.Beijing Anzhen Hospital/National Center for Cardiovascular Disease
Anzhen National Center for Cardiovascular Disease will coordinate the program implementation in Beijing. The hospital is one of the two national centers in China dedicated for cardiovascular disease prevention and control.
Heart Disease and Acute CV Events in China
- Cardiovascular diseases (CVDs) remain the biggest cause of deaths worldwide. More than 17 million people died from CVDs in 2008. Over 80 percent of CVD occurs in low- and middle-income countries, and an estimated 45 percent all CVD deaths are attributed to ischemic heart diseases, including acute myocardial infarction.1
- As China has grown economically, mortality due to ischemic heart disease has increased in incidence and has more than doubled during the past two decades to more than 1 million deaths per year.2,3 Related to this is the out-of-hospital cardiac arrest (OHCA) age-adjusted incidence which has been measured at 71.2 per 100,000 inhabitants per year in urban areas of China.4 Survival after OHCA which averages around 10% in the United States was recently shown to be just 1% in Beijing, China.4
- Quality of care has improved for some conditions in China, but important gaps in care persist demonstrated by the fact that mortality has not decreased for the most deadly type of acute myocardial infarction - ST-Elevated Myocardial Infarction (STEMI). Focused, coordinated national efforts are needed to improve the care and outcomes for patients with STEMI and OHCA in China,5 and system level data and more thorough implementation of each link in the ‘chain of survival’ for patients suffering STEMI and OHCA are needed.
- Large disparities in care and outcomes exist in China for many groups including those who cannot afford care, cannot physically access care, or have limited knowledge of their condition, their local health care system, or their rights as patients.
1. Global Atlas on Cardiovascular Disease Prevention and Control. Mendis S, Puska P, Norrving B editors. World Health Organization, Geneva 2011.
2. Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet 2013; 381: 1987–2015.
3. Omran AR. The epidemiologic transition: a theory of the epidemiology of population change. Milbank Q Dec 1971; 49: 509–38.
4. Shao F, et al. Outcome of out-of-hospital cardiac arrests in Beijing, China. Resuscitation (2014).
5. Jing Li, et al. ST-segment elevation myocardial infarction in China from 2001 to 2011 (the China PEACE-Retrospective Acute Myocardial Infarction Study): a retrospective analysis of hospital data, Lancet 2014 www.thelancet.com Published online June 24, 2014 http://dx.doi.org/10.1016/S0140-6736(14)60921-1.