James P Rhudy1, Anne W Alexandrov2, Kristiina E Hyrkäs3, Rita A Jablonski-Jaudon4, Erica R Pryor4, Henry E Wang5, Marie A Bakitas4. 1. University of Alabama at Birmingham School of Nursing, 262 Main Street, Auburn, ME 04210, USA. Electronic address: jrhudy@maine.edu. 2. University of Tennessee Health Science Center, 920 Madison, #946, Memphis, TN 38163, USA. 3. Center for Nursing Research and Quality Outcomes, Maine Medical Center, 22 Bramhall Street, Portland, ME 04102, USA. 4. University of Alabama at Birmingham School of Nursing, NB454, 1720 2nd Avenue South, Birmingham, AL 35294, USA. 5. Department of Emergency Medicine, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35233, USA.
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.
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.
Authors: Teppo Repo; Markku Tykkyläinen; Juha Mustonen; Tuomas T Rissanen; Matti Ketonen; Maija Toivakka; Tiina Laatikainen Journal: Int J Environ Res Public Health Date: 2018-04-11 Impact factor: 3.390