Geographic access to interventional cardiology services in one rural state

Abstract Objectives Explore (1) the characteristics of the Maine population with delayed geographic access to interventional cardiology (IC) services and (2) the effect of delayed geographic IC access on coronary mortality. Background Acute coronary syndrome (ACS), ST-segment elevated myocardial inf...

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Bibliographic Details
Published in:Heart & lung 2016-09, Vol.45 (5), p.434-440
Main Authors: Rhudy, James P., PhD, DNP, APRN, CCNS, CCRN-CMC-CSC, PhD graduate, Alexandrov, Anne W., PhD, RN, CCRN, ANVP-BC, NVRN-BC, FAAN, Hyrkäs, Kristiina E., PhD, LicNSc, MNSc, RN, Jablonski-Jaudon, Rita A., PhD, CRNP, ANP-BC, FAAN, Pryor, Erica R., PhD, RN, Wang, Henry E., MD, MS, Bakitas, Marie A., DNSc, CRNP, NP-C, AOCN, ACHPN, FAAN
Format: Article
Language:English
Subjects:
Access to health care
Acute coronary syndrome
Acute Coronary Syndrome - surgery
Aged
Cardiology
Cardiovascular
Coronary Care Units
Critical Care
Delivery of Health Care - methods
Female
Geographic information system
Geography
Health care access
Health services
Health Services Accessibility - organization & administration
Heart attacks
Humans
Male
Middle Aged
Mortality
Myocardial Infarction - surgery
Pulmonary/Respiratory
Risk Factors
Rural Health Services - organization & administration
Rural Population
ST-Segment elevated myocardial infarction
Time-to-Treatment
Treatment Outcome
United States
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Summary:Abstract Objectives Explore (1) the characteristics of the Maine population with delayed geographic access to interventional cardiology (IC) services and (2) the effect of delayed geographic IC access on coronary mortality. Background Acute coronary syndrome (ACS), ST-segment elevated myocardial infarction (STEMI), and non-ST segment elevated myocardial infarction (NSTEMI) are highly prevalent. Coronary mortality is minimized when victims have prompt IC access. Methods The study design was (1) an exploration of census data to investigate disparities in geographic IC access and (2) a secondary analysis of administrative claims data to investigate coronary mortality relative to delayed geographic IC access. Results Delayed access was associated in the Maine population with rural residence, advanced age, high school education, and lack of health insurance. Delayed access was associated with increased unadjusted coronary mortality, but not age-adjusted coronary mortality. Conclusion Delayed geographic IC access was associated with disparity but not with increased age-adjusted coronary mortality.
ISSN:0147-9563
1527-3288
DOI:10.1016/j.hrtlng.2016.07.002