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BMC Health Services Research
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

The effect of a regional care model on cardiac catheterization rates in patients with Acute Coronary Syndromes

Authors: Helen J Curran, Jaroslav Hubacek, Danielle Southern, Diane Galbraith, Merril L Knudtson, William A Ghali, Michelle M Graham

Published in: BMC Health Services Research | Issue 1/2014

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Abstract

Background

Patients with ACS often present to community hospitals without on-site cardiac catheterization and revascularization therapies. Transfer to specialized cardiac procedural centers is necessary to provide access to these procedures. We evaluated process of care within a regional care model by comparing cardiac catheterization and revascularization rates and outcomes in ACS patients presenting to community and interventional hospitals.

Methods

We evaluated a total of 6154 patients with ACS admitted to Southern Alberta hospitals (where a distinct regional care model for ACS exists) between January 1, 2005 and December 31, 2009. We compared cardiac catheterization and revascularization rates during index hospitalization among patients admitted to community and interventional hospitals. Thirty day and 1-year survival were also evaluated.

Results

Catheterization was performed more often in patients presenting to community hospitals compared to the interventional facility (respectively 69.5% and 51.4%, p < 0.0001). Catheterization within 72 hours of admission occurred in 48% of patients presenting to the interventional center and in 68.3% of community patients (P < 0.0001). In patients undergoing catheterization, revascularization (PCI and/or CABG) was also performed more frequently in the community group (74.5% vs 56.1%, P < 0.0001). Risk adjusted mortality rates were the same for patients undergoing cardiac catheterization regardless of hospital of initial presentation.

Conclusion

ACS patients presenting to community centers associated with a regional care model had effective access to cardiac catheterization and revascularization. These findings support the importance of regional initiatives and processes of care that facilitate access to cardiac catheterization for all ACS patients.
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Metadata
Title
The effect of a regional care model on cardiac catheterization rates in patients with Acute Coronary Syndromes
Authors
Helen J Curran
Jaroslav Hubacek
Danielle Southern
Diane Galbraith
Merril L Knudtson
William A Ghali
Michelle M Graham
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-014-0550-0

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