Access to cardiac interventional services in Alabama and Mississippi: a geographical information system analysis

Area of Science:

• Public Health
• Health Services Research
• Geographic Information Systems (GIS)

Background:

• Geographic access to healthcare services is a critical determinant of patient outcomes.
• Understanding the relationship between proximity to cardiac interventional services (CIS) and mortality rates is essential for public health planning.
• Previous studies have explored access to care, but the specific impact of distance to CIS on county-level mortality needs further investigation.

Purpose of the Study:

• To assess the influence of distance to hospitals offering cardiac interventional services (CIS) on county age-adjusted myocardial infarction (MI) mortality rates (CAMR) in Alabama and Mississippi.
• To quantify the contribution of geographic access to CIS in explaining variations in MI mortality across counties.

Main Methods:

• Utilized U.S. Census, CDC mortality, and American Hospital Association data.
• Employed a geographical information system (GIS) to empirically measure county access to CIS.
• Conducted multiple regression analysis with distance to CIS, rural status, state, sex, poverty, education, race, and interaction terms as predictors of CAMR.

Main Results:

• The overall regression model significantly predicted CAMR, explaining 31.9% of the variability (adjusted R² = .319, p < .001).
• Distance to CIS was not found to be a statistically significant predictor of CAMR.
• Statistically significant interactions revealed that CAMR was sensitive to complex patterns related to rural status, poverty, education, and race.

Conclusions:

• Geographic location of CIS, as measured by distance, did not directly influence county-level myocardial infarction mortality rates.
• Complex socioeconomic and demographic factors, including rurality, poverty, education, and race, significantly interact with cardiac outcomes.
• Future interventions should consider these multifaceted determinants of cardiac mortality beyond simple geographic proximity to specialized services.