| The effect of place of residence on access to invasive cardiac services following acute myocardial infarction. | |
| | |
MedLine Citation:
|
PMID: 19340343 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The Canadian health care system is mandated to provide reasonable access to health care for all Canadians regardless of age, sex, race, socioeconomic status or place of residence. In the present study, the impact of place of residence in Nova Scotia on access to cardiac catheterization and long-term outcomes following an acute myocardial infarction (MI) were examined. METHODS: All patients with an acute MI who were hospitalized between April 1998 and December 2001 were identified. Place of residence was defined by postal code and separated into three categories: metropolitan area (MA); nonmetropolitan urban area (UA); and rural area (RA). Rates of and waiting times for cardiac catheterization were determined, as were risk-adjusted long-term rates of mortality and readmission to the hospital. RESULTS: A total of 7351 patients were hospitalized with an acute MI during the study period. Rates of cardiac catheterization differed across the three groups (MA 45.6%, UA 37.3%, RA 37.3%; P<0.0001), as did mean waiting times (MA 15.0 days, UA 32.1 days, RA 28.7 days) (P<0.0001). After adjusting for differences among patients, residence in either UA or RA emerged as an independent predictor of lower rates of cardiac catheterization (UA: hazard ratio [HR] 0.77, P<0.0001; RA: HR 0.75, P<0.0001), greater waiting times (UA: an additional 14.1 days, P<0.0001; RA: an additional 10.8 days, P<0.0001) and increased long-term rates of readmission (UA: HR 1.24, P=0.0001; RA: HR 1.12, P=0.04). CONCLUSION: In patients admitted with an acute MI, residence outside of an MA was associated with diminished rates of cardiac catheterization, longer waiting times and increased rates of readmission. Despite universal health care coverage, Canadians are subject to significant geographical barriers to cardiac catheterization with associated poorer outcomes. |
| | |
Authors:
|
Ansar Hassan; Neil J Pearce; Jim Mathers; Paul J Veugelers; Gregory M Hirsch; Jafna L Cox; |
Related Documents
:
|
15655133 - Heart failure and death after myocardial infarction in the community: the emerging role... 17893003 - Infarct size, ejection fraction, and mortality in diabetic patients with acute myocardi... 18372443 - Percutaneous management of chronic deep venous reflux: review of experimental work and ... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: The Canadian journal of cardiology Volume: 25 ISSN: 1916-7075 ISO Abbreviation: Can J Cardiol Publication Date: 2009 Apr |
Date Detail:
|
Created Date: 2009-04-02 Completed Date: 2009-04-28 Revised Date: 2010-09-22 |
Medline Journal Info:
|
Nlm Unique ID: 8510280 Medline TA: Can J Cardiol Country: Canada |
Other Details:
|
Languages: eng Pagination: 207-12 Citation Subset: IM |
Affiliation:
|
Department of Surgery, Dalhousie University, Halifax, Canada. ahassan@dal.ca |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Female Health Services Accessibility / statistics & numerical data* Heart Catheterization / utilization* Humans Male Middle Aged Myocardial Infarction / therapy* Nova Scotia Outcome Assessment (Health Care) Patient Readmission / statistics & numerical data Registries Residence Characteristics Rural Health Services / statistics & numerical data* Urban Health Services / statistics & numerical data* |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Coordination between primary and secondary healthcare in Denmark and Sweden.
Next Document: Iron overload thalassemic cardiomyopathy: iron status assessment and mechanisms of mechanical and el...