Key result
Rural residence linked to ~49% higher 7-day AMI mortality vs urban residence.
Why the study?
Interhospital transfer rates and clinical outcomes of patients with AMI may differ between rural and urban areas due to disparities in healthcare resources and access.
Cohort (n=69,899)
Hazard Ratio: 1.49 (95% CI 1.18–1.87)
Highlights rural AMI mortality gaps; hypothesis-generating for targeted access and transfer interventions.
OBJECTIVES: This study investigated the risk associated with interhospital transfer of patients with acute myocardial infarction (AMI) and clinical outcomes according to the location of the patient' residence. DESIGN: A nationwide longitudinal cohort. SETTING: National Health Insurance Service database of South Korea. PARTICIPANTS: This study included 69 899 patients with AMI who visited an emergency centre from 2013 to 2015, as per the Korea National Health Insurance Service database. PRIMARY OUTCOME MEASURE: The clinical outcome of a patient with AMI was defined as mortality within 7 days, 30 days and 1 year. RESULTS: Clinical outcomes were analysed and compared with respect to the location of the patient's residence and occurrence of interhospital transfer. We concluded that the HR of mortality within 7 days was 1.49 times higher (95% CI 1.18 to 1.87) in rural patients than in urban patients not subjected to interhospital transfer and 1.90 times higher (95% CI 1.13 to 3.19) in transferred rural patients than in non-transferred urban patients. CONCLUSIONS: To reduce health inequality in rural areas, a healthcare policy considering regional characteristics, rather than a central government-led, catch-all approach to healthcare policy, must be formulated. Additionally, a local medical emergency delivery system, based on allocation of roles between different medical facilities in the region, must be established.
No takes yet. Share an insight, caveat, or question.
Kim et al. (2020) conducted a cohort in Acute myocardial infarction (n=69,899). Rural residence (without interhospital transfer) vs. Urban residence (without interhospital transfer) was evaluated on Mortality within 7 days (HR 1.49, 95% CI 1.18 to 1.87). Rural residence was associated with a 1.49-fold higher risk of 7-day mortality without interhospital transfer and a 1.90-fold higher risk with transfer compared to urban residence in AMI patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: