학술논문
Differential benefits of cardiac care regionalization based on driving time to percutaneous coronary intervention
Document Type
article
Author
Source
Academic Emergency Medicine. 28(5)
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Language
Abstract
BackgroundPatients with ST-elevation myocardial infarction (STEMI) require timely reperfusion, and percutaneous coronary intervention (PCI) decreases morbidity and mortality. Regionalization of STEMI care has increased timeliness and use of PCI, but it is unknown whether benefits to regionalization depend on a community's distance from its nearest PCI center. We sought to determine whether STEMI regionalization benefits, measured by access to PCI centers, timeliness of treatment (same-day or in-hospital PCI), and mortality, differ by baseline distance to nearest PCI center.MethodsUsing a difference-in-difference-in-differences model, we examined access to PCI-capable hospitals, receipt of PCI either on the day of admission or during the care episode, and health outcomes for patients hospitalized from January 1, 2006, to September 30, 2015.ResultsOf 139,408 patients (2006 to 2015), 51% could reach the nearest PCI center in