Percutaneous Coronary Intervention in the United States: Risk Factors for Untimely Access
Percutaneous Coronary Intervention in the United States: Risk Factors for Untimely Access
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DOI：
10.1111/1475-6773.12335
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发表时间：
2016-04-01
影响因子：
3.4
通讯作者：
Shen, Yu-Chu
中科院分区：
文献类型：
--
作者：
Hsia, Renee Y.;Shen, Yu-Chu
ObjectiveTo determine how access to percutaneous coronary intervention (PCI) is distributed across demographics.Data SourcesSecondary data from the 2011 American Hospital Association (AHA) survey data combined with 2010 Census.Study DesignWe calculated prehospital times from 32,370 ZIP codes to the nearest PCI center. We used a multivariate logit model to determine the odds of untimely access by the ZIP code's concentration of vulnerable populations.Data CollectionWe used ZIP code-level data on community characteristics from the 2010 Census and supplemented it with 2011 AHA survey data on service-line availability of PCI for responding hospitals.Principal FindingsFor approximately 306 million Americans, the median prehospital time to the nearest PCI center is 33minutes. While 84 percent of Americans live within one hour of a PCI center, the odds of untimely access are higher in low-income (OR: 3.00; 95 percent CI: 2.39, 3.77), rural (8.10; 95 percent CI: 6.84, 9.59), and highly Hispanic communities (2.55; 95 percent CI: 1.86, 3.49).ConclusionsWhile the majority of Americans live within 60minutes of a PCI center, rural, low-income, and highly Hispanic communities have worse PCI access. This may translate into worse outcomes for patients with acute myocardial infarction.
