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December 1, 2000Australian Journal of Rural Health

Differences in Cardiac Procedures Among Patients in Metropolitan and Non‐Metropolitan Hospitals in New South Wales After Acute Myocardial Infarction and Angina

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Key result

Admission to metropolitan hospitals was associated with significantly higher odds of inpatient coronary angiography for AMI compared to non-metropolitan hospitals (OR 68.64; 95% CI 17.29-272.49).

Why the study?

Does admission to a metropolitan hospital compared to a non-metropolitan hospital increase the use of cardiac procedures in patients with acute myocardial infarction or angina?

Population

3,836 patients admitted to hospital after acute myocardial infarction, unstable angina, or other angina…

Comparison

Admission to a metropolitan hospital vs Admission to a non-metropolitan hospital

Design

Cohort

Follow-up

22 months

Authors

RHRichard F HellerGeneral / Preventive / LipidsRORachel O’ConnellRoyal Marsden NHS Foundation TrustCDCatherine D’EsteSax Institute

Discussion

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Overview

Highlights potential AMI care access disparities; leaves open whether confounding drives the association or targeted interventions could improve equity.

Study Design

Type

Cohort (n=3,836)

Multicenter

Yes

Structured PICO

Does admission to a metropolitan hospital compared to a non-metropolitan hospital increase the use of cardiac procedures in patients with acute myocardial infarction or angina?

P
Population
3,836 patients admitted to 47 hospitals for acute myocardial infarction or angina, with follow-up at 22 months completed on 1,695 patients.
E
Exposure
Admission to a metropolitan hospital
C
Comparator
Admission to a non-metropolitan hospital
O
Outcome
Use of cardiac procedures (exercise stress tests, echocardiograms, nuclear studies, and coronary angiography) during hospital admission and at 22 months post-discharge

Main Result

Odds Ratio: 68.64 (95% CI 17.29–272.49)

There is a massive disparity in the utilization of inpatient cardiac procedures, particularly coronary angiography, between metropolitan and non-metropolitan hospitals for patients with acute coronary syndromes.

Cite This Study

Heller et al. (2000) conducted a cohort in Acute myocardial infarction and angina (n=3,836). Admission to metropolitan hospitals vs. Admission to non-metropolitan hospitals was evaluated on Inpatient use of coronary angiography for acute myocardial infarction (OR 68.64, 95% CI 17.29-272.49). Admission to metropolitan hospitals was associated with significantly higher odds of inpatient coronary angiography for AMI compared to non-metropolitan hospitals (OR 68.64; 95% CI 17.29-272.49).

synapsesocial.com/papers/6a99e1db4e49e699219e3bechttps://doi.org/10.1046/j.1440-1584.2000.00300.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Comparison of Management Patterns after Acute Myocardial Infarction in Canada and the United States1993 · 313 citations
  2. 2Influence of Payor on Use of Invasive Cardiac Procedures and Patient Outcome After Myocardial Infarction in the United States1998 · 98 citations
  3. 3Coronary revascularisation: why do rates vary geographically in the UK?1995 · 92 citations
  4. 4Determinants of the Use of Coronary Angiography and Revascularization after Thrombolysis for Acute Myocardial Infarction1996 · 167 citations
  5. 5Mortality after acute myocardial infarction is lower in metropolitan regions than in non-metropolitan regions2000 · 33 citations