Access to myocardial revascularization procedures

Closing the gap with time?

Alain Vanasse, Théophile Niyonsenga, Josiane Courteau, Abbas Hemiari

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Early access to revascularization procedures is known to be related to a more favorable outcome in myocardial infarction (MI) patients, but access to specialized care varies widely amongst the population. We aim to test if the early gap found in the revascularization rates, according to distance between patients' location and the closest specialized cardiology center (SCC), remains on a long term basis. Methods: We conducted a population-based cohort study using data from the Quebec's hospital discharge register (MED-ECHO). The study population includes all patients 25 years and older living in the province of Quebec, who were hospitalized for a MI in 1999 with a follow up time of one year after the index hospitalization. The main variable is revascularization (percutaneous transluminal coronary angioplasty or a coronary artery bypass graft). The population is divided in four groups depending how close they are from a SCC (<32 km, 32-64 km, 64-105 km and ≥105 km). Revascularization rates are adjusted for age and sex. Results: The study population includes 11,802 individuals, 66% are men. The one-year incidence rate of MI is 244 individuals per 100,000 inhabitants. At index hospitalization, a significant gap is found between patients living close (< 32 km) to a SCC and patients living farther (≥32 km). During the first year, a gap reduction can be observed but only for patients living at an intermediate distance from the specialized center (64-105 km). Conclusion: The gap observed in revascularization rates at the index hospitalization for MI is in favour of patients living closer (< 32 km) to a SCC. This gap remains unchanged over the first year after an MI except for patients living between 64 and 105 km, where a closing of the gap can be noticed.

Original languageEnglish
Article number60
Pages (from-to)1-7
Number of pages7
JournalBMC Public Health
Volume6
DOIs
Publication statusPublished - 2006
Externally publishedYes

Fingerprint

Myocardial Revascularization
Cardiology
Myocardial Infarction
Hospitalization
Quebec
Population
Coronary Balloon Angioplasty
Coronary Artery Bypass
Cohort Studies
Transplants
Incidence

Cite this

Vanasse, Alain ; Niyonsenga, Théophile ; Courteau, Josiane ; Hemiari, Abbas. / Access to myocardial revascularization procedures : Closing the gap with time?. In: BMC Public Health. 2006 ; Vol. 6. pp. 1-7.
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Access to myocardial revascularization procedures : Closing the gap with time? / Vanasse, Alain; Niyonsenga, Théophile; Courteau, Josiane; Hemiari, Abbas.

In: BMC Public Health, Vol. 6, 60, 2006, p. 1-7.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Access to myocardial revascularization procedures

T2 - Closing the gap with time?

AU - Vanasse, Alain

AU - Niyonsenga, Théophile

AU - Courteau, Josiane

AU - Hemiari, Abbas

PY - 2006

Y1 - 2006

N2 - Background: Early access to revascularization procedures is known to be related to a more favorable outcome in myocardial infarction (MI) patients, but access to specialized care varies widely amongst the population. We aim to test if the early gap found in the revascularization rates, according to distance between patients' location and the closest specialized cardiology center (SCC), remains on a long term basis. Methods: We conducted a population-based cohort study using data from the Quebec's hospital discharge register (MED-ECHO). The study population includes all patients 25 years and older living in the province of Quebec, who were hospitalized for a MI in 1999 with a follow up time of one year after the index hospitalization. The main variable is revascularization (percutaneous transluminal coronary angioplasty or a coronary artery bypass graft). The population is divided in four groups depending how close they are from a SCC (<32 km, 32-64 km, 64-105 km and ≥105 km). Revascularization rates are adjusted for age and sex. Results: The study population includes 11,802 individuals, 66% are men. The one-year incidence rate of MI is 244 individuals per 100,000 inhabitants. At index hospitalization, a significant gap is found between patients living close (< 32 km) to a SCC and patients living farther (≥32 km). During the first year, a gap reduction can be observed but only for patients living at an intermediate distance from the specialized center (64-105 km). Conclusion: The gap observed in revascularization rates at the index hospitalization for MI is in favour of patients living closer (< 32 km) to a SCC. This gap remains unchanged over the first year after an MI except for patients living between 64 and 105 km, where a closing of the gap can be noticed.

AB - Background: Early access to revascularization procedures is known to be related to a more favorable outcome in myocardial infarction (MI) patients, but access to specialized care varies widely amongst the population. We aim to test if the early gap found in the revascularization rates, according to distance between patients' location and the closest specialized cardiology center (SCC), remains on a long term basis. Methods: We conducted a population-based cohort study using data from the Quebec's hospital discharge register (MED-ECHO). The study population includes all patients 25 years and older living in the province of Quebec, who were hospitalized for a MI in 1999 with a follow up time of one year after the index hospitalization. The main variable is revascularization (percutaneous transluminal coronary angioplasty or a coronary artery bypass graft). The population is divided in four groups depending how close they are from a SCC (<32 km, 32-64 km, 64-105 km and ≥105 km). Revascularization rates are adjusted for age and sex. Results: The study population includes 11,802 individuals, 66% are men. The one-year incidence rate of MI is 244 individuals per 100,000 inhabitants. At index hospitalization, a significant gap is found between patients living close (< 32 km) to a SCC and patients living farther (≥32 km). During the first year, a gap reduction can be observed but only for patients living at an intermediate distance from the specialized center (64-105 km). Conclusion: The gap observed in revascularization rates at the index hospitalization for MI is in favour of patients living closer (< 32 km) to a SCC. This gap remains unchanged over the first year after an MI except for patients living between 64 and 105 km, where a closing of the gap can be noticed.

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M3 - Article

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SP - 1

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JO - BMC Public Health

JF - BMC Public Health

SN - 1471-2458

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