Geographic clustering of emergency department presentations for acute coronary syndromes and heart failure in Alberta: a population-based study

Abstract

T he emergency department is often the initial point of contact with the health care system for patients with new-onset cardiac conditions or exacerbations of chronic cardiac conditions. Collectively, the most common acute cardiac presentations to the emergency department are acute coronary syndromes (ACSs) and heart failure.1 The literature on these important conditions in the emergency department setting in Canada is surprisingly limited. In particular, geographic variation has not received much attention, and such variation may represent greater severity of illness, lesser availability of health care resources, variation in delivery of health care services or a combination of these factors.The aim of this study was to examine geographic variation in visits by adults (aged ≥ 35 yr) to emergency departments with presentations attributed to ACS or heart failure in Alberta during 2010/11. We have previously identified clusters of patients presenting to the emergency department for atrial fibrillation and flutter 2 and wished to further examine geographic variation in cardiac conditions in Alberta. Methods Study design and settingThis study is a retrospective cohort study using populationbased administrative health databases in Alberta from Apr. 1, 2010, to Mar. 31, 2011. Sources of dataWe extracted data from 5 Alberta administrative health databases: 1) the Morbidity and Ambulatory Care Abstract Reporting for emergency department presentations, 2) the Alberta Health Care Insurance Plan cumulative registry file Geographic clustering of emergency department presentations for acute coronary syndromes and heart failure in Alberta: a population-based study Rhonda Background: Collectively, the most common acute cardiac presentations to emergency departments are acute coronary syndromes (ACSs) and heart failure. We examined geographic variation and clustering in emergency department presentations by adults for ACS or heart failure in Alberta in 2010/11.

Despite Having Worse Risk Profiles, Northern Albertans Wait Longer for Specialist Follow-up After Emergency Department Visits for Atrial Fibrillation

“… 28 We also examined geographic clustering of higher numbers of patients presenting to Alberta EDs in 2010-2011 for acute coronary syndromes and heart failure. 29 Similar clusters were identified for the 2 conditions (northwest and southeast areas for acute coronary syndromes and north and southeast areas for heart failure). Most of the characteristics related to use of health care services (prior hospital admission, ED presentation, physician claims) were higher in number for patients in the clusters.…”