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Comparison between urban and rural mortality in patients with acute myocardial infarction: a nationwide longitudinal cohort study in South Korea.
Kim, Hye Sim; Kang, Dae Ryong; Kim, Inah; Lee, Kyungsuk; Jo, Hoon; Koh, Sang Baek.
Afiliación
  • Kim HS; Center of Biomedical Data Science, Yonsei University Wonju College of Medicine, Wonju, South Korea.
  • Kang DR; Department of Precision Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
  • Kim I; Department of Occupational and Environmental Medicine, Hanyang University College of Medicine, Seongdong-gu, South Korea.
  • Lee K; National Institute of Agricultural Science, Rural Development Administration, Jeonju, South Korea.
  • Jo H; Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
  • Koh SB; Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea kohhj@yonsei.ac.kr.
BMJ Open ; 10(4): e035501, 2020 04 08.
Article en En | MEDLINE | ID: mdl-32273319
OBJECTIVES: This study investigated the risk associated with interhospital transfer of patients with acute myocardial infarction (AMI) and clinical outcomes according to the location of the patient' residence. DESIGN: A nationwide longitudinal cohort. SETTING: National Health Insurance Service database of South Korea. PARTICIPANTS: This study included 69 899 patients with AMI who visited an emergency centre from 2013 to 2015, as per the Korea National Health Insurance Service database. PRIMARY OUTCOME MEASURE: The clinical outcome of a patient with AMI was defined as mortality within 7 days, 30 days and 1 year. RESULTS: Clinical outcomes were analysed and compared with respect to the location of the patient's residence and occurrence of interhospital transfer. We concluded that the HR of mortality within 7 days was 1.49 times higher (95% CI 1.18 to 1.87) in rural patients than in urban patients not subjected to interhospital transfer and 1.90 times higher (95% CI 1.13 to 3.19) in transferred rural patients than in non-transferred urban patients. CONCLUSIONS: To reduce health inequality in rural areas, a healthcare policy considering regional characteristics, rather than a central government-led, catch-all approach to healthcare policy, must be formulated. Additionally, a local medical emergency delivery system, based on allocation of roles between different medical facilities in the region, must be established.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Población Rural / Población Urbana / Transferencia de Pacientes / Disparidades en Atención de Salud / Infarto del Miocardio Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: BMJ Open Año: 2020 Tipo del documento: Article País de afiliación: Corea del Sur Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Población Rural / Población Urbana / Transferencia de Pacientes / Disparidades en Atención de Salud / Infarto del Miocardio Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: BMJ Open Año: 2020 Tipo del documento: Article País de afiliación: Corea del Sur Pais de publicación: Reino Unido