Variations by health region in treatment and survival after heart attack.

This article examines geographical variations in 30-day revascularization rates and 30-day in-hospital mortality rates for Canadian heart attack (acute myocardial infarction) patients. The data are from the Health Person-Oriented Information Database and pertain to health regions with at least 100,000 population in seven provinces for the years 1995/1996 and 2003/2004. Revascularization rates rose in all health regions between these years, and mortality rates dropped in most, but not all, regions. Generally, health regions with high revascularization rates had lower mortality rates. However, some regions with high revascularization rates had relatively high mortality rates, and some with relatively low revascularization rates achieved relatively low mortality rates. These results raise important questions about the overall efficiency of health care in Canada, and suggest that better data are needed to support research on explaining the wide geographical variations in treatment and survival rates for heart attack patients.