The Effect of Residence in Underserved Emergency Medical Services Areas on Awareness of Myocardial Infarction Symptoms in Korea

Abstract

Objectives: The purpose of this study is to investigate the awareness level of myocardial infarction (MI) symptoms for the residents in the underserved and deserved emergency medical services areas and verify the effect of the existence of residence in the underserved emergency medical services areas on the awareness of MI symptoms. Methods: This is a cross sectional study by using the data of the 2017 Korea Community Health Survey. The residence in the underserved emergency medical services areas is defined as being targeted to the residents in 101 areas notified in ⸢Emergency Medical Service Act⸥. The awareness of MI symptoms was classified as being aware of all five items of MI symptoms. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are computed by multivariable logistic regression. Results: Of the total 195,246 subjects, 43.6% were aware of MI symptoms (43.7% and 43.6% of underserved and deserved emergency medical services areas, respectively). The residence in the underserved emergency medical services areas was associated with the awareness of MI symptoms (aOR 1.15, 95% CI=1.11-1.18). In addition, this study has found that gender, age, education level, income level, occupation, subjective stress level, drinking frequency, current smoking, and diagnosis of hypertension and diabetes were factors influencing the awareness of MI symptoms. Conclusions: Continuous efforts are needed to increase the awareness of MI symptoms for the residents in the underserved and deserved emergency medical services areas. Education and promotion should be conducted in consideration of gender, age, education level, income level, and occupation to improve the awareness of MI symptoms.

Engaging social activities prevent stroke and myocardial infraction by raising awareness of warning symptoms: A cross-sectional survey study

“…First, sex was found to be an influential predictor of symptom awareness. Women exhibited higher knowledge than men both for stroke and MI, which is consistent with the results of previous studies ( 13 , 17 , 18 , 21 , 25 ). Given that the incidence of stroke and MI is higher in men than in women ( 8 ), further intervention to raise awareness, especially among men is needed.…”

“…In contrast, young adults lack chances to encounter such situations, and even so, they may not be much interested in health issues. The elderly aged 70 years and older seem to have difficulty in recognizing the warning symptoms due to under education or cognitive impairment ( 18 , 21 ).…”

“…The region of residence was also associated with symptom awareness of stroke and MI, with individuals living in rural areas having higher awareness levels than those living in capital or urban areas. Preceding studies have explained that national projects to spread the knowledge about CVDs may have been more actively promoted in rural areas where emergency treatment is not easily accessible ( 16 , 18 ). In addition, rural dwellers tend to establish closer connections with their neighbors than city dwellers, which can lead to a higher chance of sharing health knowledge ( 26 ).…”

“…Previous studies have reported various factors that are associated with the level of knowledge about the warning symptoms of CVDs, including sex, age, race, region, marital status, education level, income, occupation, smoking, drinking, physical activity, and comorbidities (13)(14)(15)(16)(17)(18)(19)(20)(21). In fact, there exist several routes for people to learn about the warning symptoms of CVDs, for example through family members, mass media, school class, workplace, and hospital visit.…”

Factors related to the frequent use of emergency department services in Korea

“…Place of residence characteristics: These characteristics included information regarding the status of emergency medical services (underserved or not), the number of emergency medical institutions and number of beds available in the area, and the regional income decile. Areas lacking emergency medical services were identified from those announced by the Ministry of Health and Welfare [ 19 , 27 ]. Regarding the number of emergency medical institutions and beds, data were categorized using the following criteria: the number of emergency medical institutions per million residents in the city (Si), county (Gun), and district (Gu) of residence, and whether the number of beds in institutions above the hospital-clinic level was above or below that of the national average.…”