Medical facilities in the neighborhood and incidence of sudden cardiac arrest

Abstract

We did not observe a protective association between medical facilities in the home census tract and SCA risk, orbetween major medical centers in the event census tract and survival.

Patterns in Geographic Access to Health Care Facilities Across Neighborhoods in the United States Based on Data From the National Establishment Time-Series Between 2000 and 2014

“…The NETS data represent a census of all businesses across the United States, and the NETS is considered one of the most comprehensive databases of establishments available. Prior studies 2,23,24 have used the NETS data to examine health care facilities and specific chronic conditions. From the NETS, records were categorized as ambulatory care facilities or as pharmacies and drugstores using SIC codes (eTable 1 in the Supplement).…”

“…After examining the distribution of counts, CTs were classified as having none vs any for each type of health care facility (ambulatory care facilities or pharmacies and drugstores). Census tracts were divided into the following 4 trajectories of health care facility presence over time between 2000 and 2014: (1) never having any facilities (CTs having none at both time points), (2) losing (CTs going from having at least 1 to having none), (3) gaining (CTs going from having none to having at least 1), and (4) always having a facility (CTs having at least 1 at both time points). geographies and measurements over time.…”

The Association of Neighborhood Medical Facilities with Aging in Place and Risk of Incident Myocardial Infarction

“…With respect to the time-to-MI analysis, our study provided further evidence to support previously identified demographic and other risk factor characteristics associated with an increased risk of MI. The lack of a significant association between medical facility exposures and MI events coupled with prior findings (Goh et al, 2018) casts doubt on their salience and may indicate that other neighborhood level amenities and features, or neighborhood features accessible during earlier periods of life, have greater potential for explaining both aging in place and time -to -MI.…”

“…We measured medical facilities and other neighborhood level characteristics in 5 km buffers in order to represent a reasonable distance that someone might comfortably travel to seek medical care. It is also thought that the densities of businesses and features in this size buffer can have the greatest potential to affect health, a strategy inspired by Goh et al (2018). Realistically, individuals may travel much closer or farther to seek medical care, and thus our measurement of the density of medical facilities and other features in 5 km radial buffers may not capture care-seeking behavior, thus potentially missing associations that may exist.…”

“…Participants were informed if their laboratory values exceeded normal range and were recommended to seek medical care if their laboratory values exceeded critical thresholds using clinical guidelines from three sources: (1) the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; (2) the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults; and (3) the American Diabetes Association criteria for diabetes mellitus (Detection & Adults, 2002; Harris et al, 1997; “The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure,” 1997). Individual level covariate choice was influenced by previous research around risk factors for incident MI and residential stability (Goh et al, 2018; Safford et al, 2012; Sergeant et al, 2010).…”