优势和劣势社区心脏病发作患者的不同治疗方法和结果
Yu-Chu Shen1,2, Nandita Sarkar2, Renee Y Hsia3,4
1Department of Defense Management Naval Postgraduate School Monterey CA USA.
Journal of the American Heart Association
|August 30, 2023
概括
弱势社区的患者在心脏病发作后接受皮肤冠状动脉干预 (PCI) 的时间较少. 这导致死亡率和再接收率高于优势地区的再接收率.
科学领域:
- 心血管医学 心血管医学
- 医疗保健服务研究 医疗服务研究
- 健康 公平 卫生 公平
背景情况:
- 对于少数群体,低收入和农村人口来说,穿皮冠状动脉干预 (PCI) 的获得是不平等的.
- 在富裕地区,PCI医院更为普遍,加剧了差距.
- 区域贫困指数 (ADI) 是衡量社区社会经济地位的工具.
研究的目的:
- 分析急性心肌梗塞 (AMI) 患者PCI接入,治疗和治疗结果的差异.
- 评估社区层面社会经济地位 (使用ADI) 对PCI利用和患者结果的影响.
- 根据社区贫困状况确定差异.
主要方法:
- 利用了加利福尼亚州629419名AMI患者的患者级数据 (2006-2020年).
- 将患者数据与社区特征和地理信息联系起来.
- 根据ADI将社区分为五组,以比较PCI接入,治疗和结果.
主要成果:
- 在最有利的社区中,患者接受同一天PCI (20%) 和住院PCI (15%) 的可能性更高.
- 优势社区的30天 (19%) 和1年 (16%) 死亡率较低,30天再入院率较低 (15%).
- 社区群体之间没有发现可接受PCI医院入院的显著差异.
结论:
- 处于不利地位的社区经历了为AMI及时提供PCI的减少.
- 贫困地区的患者在PCI后面临死亡和再入院的风险增加.
- 需要有针对性的干预措施来改善心脏服务的地理分布和可访问性.
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