Is it possible to distribute a scarce resource equitably? Access to invasive procedures for patients with acute myocardial infarction

N Z Med J. 2007 Mar 2;120(1250):U2446.

Abstract

Aims: To compare waiting times for inpatient cardiac catheterisation between a hospital with on-site cardiac catheterisation facility (Auckland City Hospital, ACH) and one of its referring hospitals (North Shore Hospital, NSH).

Methods: Patients were included if they were admitted ACH or NSH with a myocardial infarction, and subsequently underwent inpatient coronary angiography.

Results: 853 patients were identified from NSH and 600 from ACH. Patients from NSH waited significantly longer for coronary angiography (median delay 6 versus 3 days, p<0.0009) and fewer underwent this procedure within 48 hours of admission (11% versus 36%, p<0.0009). Delays in percutaneous coronary intervention were significantly longer for NSH patients (6 versus 3 days, p<0.0009), and fewer NSH patients underwent this procedure within 48 hours (12% versus 41%, p<0.0009).

Conclusions: Inpatients with myocardial infarction waited longer for coronary angiography and percutaneous coronary intervention at a hospital without invasive facility than similar patients at the regional referral hospital with on-site invasive facility.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Cardiac Catheterization / statistics & numerical data*
  • Female
  • Hospitals / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / therapy*
  • Myocardial Revascularization / statistics & numerical data*
  • New Zealand
  • Time Factors
  • Waiting Lists*