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[Delay in hospitalization of patients with myocardial infarct]
J K Bleeker1, R A Erdman, L M Lamers
1GGD, afd. Epidemiologie, Rotterdam.
Insights
Patients with myocardial infarction now seek medical help sooner. However, delays often occur due to general practitioners' (GPs) decision-making time before hospital referral, impacting timely treatment.
Area of Science:
- Cardiology
- Pre-hospital care
Context:
- Myocardial infarction (MI) treatment timeliness is crucial for patient prognosis.
- Delays in care can stem from patient, caregiver, or general practitioner (GP) misjudgments.
Purpose:
- To investigate pre-hospital delays in myocardial infarction (MI) patient care.
- To identify specific points of delay in the patient journey from symptom onset to hospital admission.
Summary:
- A study of 300 myocardial infarction (MI) patients (March 1990-October 1991) analyzed pre-hospital care timelines.
- While patients sought help within 30 minutes (50%) and ambulances arrived promptly (90% within 15 min), GPs' decision-making for hospital referral exceeded 82 minutes in 50% of cases.
- Patients now seek help faster than in previous studies, but GP referral remains a significant delay point.
Impact:
- Findings highlight the need to improve general practitioners' (GPs) diagnostic capabilities and decision-making efficiency for myocardial infarction (MI) patients.
- Optimizing the GP referral process is essential to reduce pre-hospital delays and improve patient outcomes.
Abstract:
Timely treatment of patients with an evolving myocardial infarction improves the short and long term prognoses. Because of a wrong judgement of the situation by the patient, a significant other or by a general practitioner (GP), treatment may be delayed. To examine this delay 300 patients with myocardial infarction took part in a study between March 1990 and October 1991. After written consent was given, they were interviewed about the pre-hospital period. The significant others received a questionnaire about this period. Medical information was collected from the cardiologists. Fifty percent of all patients called for medical help within 30 minutes. The GP arrived within 11 minutes at the patient's place in 50% of all cases. However, in 50% of all cases the decision making of the GPs before the patient was sent to a hospital required more than 82 minutes. The ambulance arrived within 15 minutes at the patient's place in 90% of all cases. Stabilisation of the patient by the ambulance staff and transport to the hospital took slightly more time. Compared with earlier studies, the patient with a possible myocardial infarction calls for help sooner. Subsequently, in many cases it takes considerable time before the GP refers the patient to a hospital. Further research is needed to improve the diagnostic power of the GP.