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Emergency Room Burden of Cardiac Complications in California
Lydia Wilson1, Sasha Singh1, Daryoush Javidi2
1Medicine, California University of Science and Medicine, Colton, USA.
Insights
Emergency departments (EDs) in primary care shortage areas (PCSAs) in California face higher cardiac complication burdens. San Bernardino County EDs show significantly higher cardiac visits, necessitating localized interventions.
Area of Science:
- Public Health
- Cardiovascular Disease Epidemiology
- Healthcare Access
Background:
- San Bernardino County exhibits elevated cardiovascular disease (CVD) mortality rates and primary care physician shortages compared to California averages.
- These disparities impact emergency department (ED) utilization, particularly for cardiac-related emergencies.
- Understanding the ED burden of cardiac complications is crucial for targeted public health interventions.
Purpose of the Study:
- To assess the burden of cardiac complications on EDs in San Bernardino County and across California.
- To compare the cardiac-related ED burden between hospitals within and outside of primary care shortage areas (PCSAs).
- To identify regional disparities in cardiac-related ED visits.
Main Methods:
- Utilized data from the California Health and Human Services Open Data Portal.
- Conducted baseline comparisons of average ED visit rates for cardiac-related conditions.
- Employed independent samples t-tests to analyze statistically significant differences in ED burden between PCSA and non-PCSA hospitals and across California regions.
Main Results:
- Cardiac-related ED visit rates did not significantly differ by PCSA designation within San Bernardino County (p > 0.05).
- However, PCSA hospitals in Southern California and statewide showed significantly higher rates of cardiac-related ED visits (p < 0.05).
- San Bernardino County EDs experienced significantly higher rates of cardiac-related visits compared to the rest of Southern California and California (p < 0.001).
Conclusions:
- Elevated cardiac-related ED visits in California's PCSAs underscore the need to improve primary care access and CVD prevention strategies.
- The substantial ED burden of cardiac cases in San Bernardino County necessitates region-specific interventions.
- Addressing healthcare access disparities is critical for mitigating the impact of cardiovascular disease on emergency services.
Abstract:
Introduction San Bernardino County has higher age-adjusted death rates due to cardiovascular disease (CVD) and a higher ratio of patients to primary care physicians when compared to the rest of California. With these trends, it is important to consider the impact on emergency departments (EDs). This study examines the burden of cardiac complications on EDs in San Bernardino County and across California. Additionally, it examines the difference in cardiac-related ED burden between hospitals inside and outside of primary care shortage areas (PCSAs). Methods Data were obtained from the California Health and Human Services Open Data Portal. Baseline comparisons used the calculated averages and percentage of ED visits that were cardiac-related. Further analysis was done using independent samples t-tests on IBM SPSS Statistics 28.0.1.0 (IBM Corp., Armonk, NY), checking for statistically significant differences in ED burden between PCSA and non-PCSA hospitals and between different geographical regions of California. Results Independent samples t-tests showed that rates of cardiac-related ED visits do not differ by PCSA designation in San Bernardino (p > 0.05), but they are significantly higher in PCSA hospitals when looking at Southern California and California (p < 0.05). Additionally, rates of cardiac-related ED visits seen in San Bernardino were significantly higher than in the rest of Southern California and California (p < 0.001). Conclusion Higher rates of cardiac-related ED visits in PCSAs of Southern California and California indicate a need to address issues of primary care access and enhance preventive measures for CVD. Furthermore, the increased ED burden of cardiac cases in San Bernardino County highlights the requirement for localized intervention.
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