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Published on: December 16, 2022

Pre-Hospital and Patient Delays Among Culturally and Linguistically Diverse ST-Segment Elevation Myocardial

Ararso Baru Olani1, Kathryn Eastwood2, Stuart Howell1

  • 1School of Public Health and Preventive Medicine, Monash University, Melbourne, Vic, Australia.

Heart, Lung & Circulation
|August 20, 2026
PubMed

Insights

Culturally and linguistically diverse (CALD) patients experienced similar ST-elevation myocardial infarction (STEMI) delays overall, but longer pre-hospital delays in regional areas. Targeted interventions are crucial for improving STEMI care equity.

Area of Science:

  • Cardiology
  • Public Health
  • Health Equity

Background:

  • Limited evidence exists on pre-hospital delays for ST-elevation myocardial infarction (STEMI) among culturally and linguistically diverse (CALD) populations in Australia.
  • Understanding these delays is crucial for addressing healthcare inequities.

Purpose of the Study:

  • To compare patient and pre-hospital delays for STEMI by CALD status and geographic region in Victoria, Australia.
  • To identify factors associated with pre-hospital delays exceeding two hours among CALD patients.

Main Methods:

  • An observational study utilized linked data from the Victorian Cardiac Outcomes Registry and the Victorian Admitted Episodes Dataset (2013-2021).
  • CALD status was defined by country of birth and language preference.
  • Logistic regression analyzed associations with patient (≤60 minutes) and pre-hospital (≤2 hours) delays.

Main Results:

  • Of 11,212 STEMI patients, 31.7% were CALD.
  • Median patient and pre-hospital delays were generally similar across groups, except for longer pre-hospital delays for CALD patients preferring a language other than English (CALD-LOTE) in regional areas.
  • The 90th percentile of pre-hospital delay was 85 minutes longer for CALD-LOTE patients compared to Australian-born patients.

Conclusions:

  • While overall delays were similar, regional disparities and longer extreme delays were observed in CALD-LOTE patients.
  • Tailored interventions are necessary to address high-risk subgroups and reduce inequities in STEMI care.
Abstract

Keywords:
Emigrants and immigrantsHealthcare inequalitiesLimited English proficiencyPrehospital emergency careST elevation myocardial infarctionTreatment delay

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