Influencing factors of patient delay for decision-making in older patients with acute coronary syndrome: a study based on the Andersen’s Behavioral Model

Objective: This cross-sectional study aimed to identify factors influencing patient delay in older adults with acute coronary syndrome (ACS) using Andersen's Behavioral Model at a tertiary hospital in Zhejiang Province, China. Methods: A total of 153 older adults diagnosed with ACS who survived to hospital admission were included from January 2023 to June 2023. Logistic regression analysis was used to determine factors independently associated with a longer patient delay following symptom onset. Results: The median delay in seeking medical care was 100.00 min (55.00, 450.00 min). Female sex (odds ratio [OR] = 2.762, 95% CI: 1.067-7.153), advanced age (≥75 years; OR = 4.244, 95% CI: 1.519-11.859), diagnosis of unstable angina (OR = 3.430, 95% CI: 1.281-9.182), and history of diabetes (OR = 3.921, 95% CI: 1.364-11.273) were significant factors associated with prolonged patient delay. In contrast, attributing symptoms to cardiac disease (OR = 0.269, 95% CI: 0.088-0.823), engaging in consultation-seeking behavior following symptom onset (OR = 0.326, 95% CI: 0.124-0.856), and a history of heart disease (OR = 0.274, 95% CI: 0.095-0.790) were associated with reduced likelihood of delay. Conclusion: To reduce patient delay among older adults with ACS, it is important to improve their ability to recognize ACS symptoms, especially in female, older, and patients with diabetes, and those with cardiovascular risk factors but no prior cardiac diagnosis. Accessible consultations could support older patients in making quick decisions about care-seeking behavior.