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 (2018)

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.