Influence of distance from home to invasive centre on invasive treatment after acute coronary syndrome: a nationwide study of 24 910 patients

Abstract

In patients hospitalised with ACS, invasive examination and treatment were less likely the further away from an invasive centre the patients resided, thus equal and uniform invasive examination and treatment was not found.

Long-term Outcomes of Patients with Acute Myocardial Infarction Presenting to Regional and Remote Hospitals

“…A Scandinavian registry analysis reported reduced rates of revascularisation with increasing distances from interventional centres, but the differences in revascularisation rates reported between the cohorts are much smaller than ours and their overall rates of revascularisation were much higher [12]. This might reflect different distances, health systems or health practice.…”

“…US Medicare population data has shown markedly lower revascularisation rates and higher shortterm mortality with AMI in rural hospitals [9][10][11]. Scandinavian data has shown lower revascularisation rates with increasing distances from services, but the distances are relatively small [12]. The vast landmass and low population density of Australia is likely to be the setting most susceptible to any impact of remoteness upon health service access and patient outcomes.…”

Symptom onset-to-balloon time and mortality in the first seven years after STEMI treated with primary percutaneous coronary intervention

“…We took advantage from direct access to hospital and short distances (≤22 km in 92% of patients). In the literature, patients living at a longer distance from the PPCI centre and admitted to a local hospital prior to transportation to the PCI centre are less likely to receive PCI,17 and have longer treatment delays and increased mortality 11…”

Disparities in Revascularization Rates After Acute Myocardial Infarction Between Aboriginal and Non-Aboriginal People in Australia

“…However, these measured hospital-level factors might have been correlated with other unmeasured factors such as the time taken for the patient to get to hospital after AMI onset. 40 Communication and coordination between those hospitals capable of performing revascularization and those not, electrocardiograms in ambulances and activation of catheterization laboratories, have been shown to improve time to revascularization 41,42 and are part of new models of care being rolled out in Australia. 43 It will be important to monitor the impact of these new models of care to ensure that they contribute to a reduction in the overall state-wide disparity in revascularization rates for Aboriginal people.…”