Is it possible to distribute a scarce resource equitably? Access to invasive procedures for patients with acute myocardial infarction
Insull, P.; Kejriwal, R.; Patel, H.; Christiansen, J.; Scott, A.; Hart, H.; Edwards, C.; Armstrong, G.
New Zealand Medical Journal 120(1250): U2446
2007
ISSN/ISBN: 0028-8446 PMID: 17339902 Document Number: 612636
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). Patients were included if they were admitted ACH or NSH with a myocardial infarction, and subsequently underwent inpatient coronary angiography. 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). 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.