Association Between System Factors and Acute Myocardial Infarction Mortality
| العنوان: | Association Between System Factors and Acute Myocardial Infarction Mortality |
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| المؤلفون: | Holly C. Felix, Appathurai Balamurugan, Kevin W. Ryan, Martha M. Phillips, James P. Selig |
| المصدر: | Southern Medical Journal. 111:556-564 |
| بيانات النشر: | Southern Medical Association, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, Emergency Medical Services, medicine.medical_specialty, Time Factors, Cross-sectional study, medicine.medical_treatment, Myocardial Infarction, 030204 cardiovascular system & hematology, Health Services Accessibility, Time-to-Treatment, Odds, 03 medical and health sciences, Percutaneous Coronary Intervention, 0302 clinical medicine, Risk Factors, Odds Ratio, medicine, Emergency medical services, Humans, cardiovascular diseases, 030212 general & internal medicine, Aged, Retrospective Studies, Arkansas, Geography, business.industry, Percutaneous coronary intervention, Retrospective cohort study, General Medicine, Odds ratio, Middle Aged, Confidence interval, Cross-Sectional Studies, Logistic Models, Acute Disease, Emergency medicine, Conventional PCI, Female, business, Delivery of Health Care |
| الوصف: | Objectives We conducted a cross-sectional study to assess the association between healthcare system factors and death from acute myocardial infarction (AMI), in terms of access (distance to the hospital, mode of transportation), availability (emergency medical services, hospitals), and capability (emergency medical services' 12-lead electrocardiogram capability, continuous percutaneous coronary intervention [PCI] and cardiothoracic surgical services), after accounting for individual and environmental factors. Methods Data on 14,663 deaths (in-hospital and out of hospital) and live hospital discharges as a result of AMI for 2012 and 2013 among Arkansas residents were obtained from the Arkansas Department of Health. A mixed-effects logistic regression model was used to account for nesting, in which an individual was nested within either a county or a hospital to evaluate the association of system factors with death from AMI. Results Deaths from AMI were significantly associated with two system factors: a 9.2% increase in the odds of deaths from AMI for every 10-mi increase in distance to the nearest hospital (odds ratio 1.092, 95% confidence interval 1.009-1.181) and a 64% increase in the odds of death from AMI among hospitals without continuous PCI capability (odds ratio 1.64, 95% confidence interval 1.15-2.34), after adjusting for individual and environmental factors. Conclusions A higher risk of AMI deaths was associated with healthcare system factors, especially distance to nearest hospital, and hospitals' continuous PCI capability, even after adjusting for individual and environmental factors. A coordinated system of care approaches that mitigates gaps in these system factors may prevent death from AMI. |
| تدمد: | 1541-8243 0038-4348 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::85778906685f70f0daf549c5e1c73497Test https://doi.org/10.14423/smj.0000000000000853Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....85778906685f70f0daf549c5e1c73497 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15418243 00384348 |
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