2014
DOI: 10.1161/jaha.114.001057
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Outcomes and Resource Utilization in ST‐Elevation Myocardial Infarction in the United States: Evidence for Socioeconomic Disparities

Abstract: BackgroundSocioeconomic status (SES) as reflected by residential zip code status may detrimentally influence a number of prehospital clinical, access‐related, and transport variables that influence outcome for patients with ST‐elevation myocardial infarction (STEMI) undergoing reperfusion. We sought to analyze the impact of SES on in‐hospital mortality, timely reperfusion, and cost of hospitalization following STEMI.Methods and ResultsWe used the 2003–2011 Nationwide Inpatient Sample database for this analysis… Show more

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Cited by 60 publications
(60 citation statements)
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“…Moreover, a higher proportion of no-FHxCAD patients in our study had lower median household income, and were also more likely to be medicare insurers. Both economic and insurance has been previously associated with increased in-hospital mortality post MI due to differences in utilization of standard practice, health-care delivery systems and performance of emergency services (10,11). In addition, lower socioeconomic status has been associated with The data represent adjusted OR (95% CI).…”
Section: Discussionmentioning
confidence: 99%
“…Moreover, a higher proportion of no-FHxCAD patients in our study had lower median household income, and were also more likely to be medicare insurers. Both economic and insurance has been previously associated with increased in-hospital mortality post MI due to differences in utilization of standard practice, health-care delivery systems and performance of emergency services (10,11). In addition, lower socioeconomic status has been associated with The data represent adjusted OR (95% CI).…”
Section: Discussionmentioning
confidence: 99%
“…It is already established that patients from the area with lower SES have decreased timely reperfusion following STEMI, compared with patients from higher SES. 24 Our findings may propose a lack of resources, such as PCIcapable hospitals, in areas with lower SES. The number of PCI-capable hospitals has been increasing consistently since 2001.…”
Section: Discussionmentioning
confidence: 70%
“…This effect of the introduction of primary PCI, in which socioeconomic factors have a small impact on time to revascularisation after presenting to a healthcare facility, has also been shown in the USA. 38 Previous socioeconomic inequity may have existed over decisions on non-acute coronary revascularisation with physicians' perceptions of non-clinical factors, such as low SES, unhealthy lifestyle and lack of social support, having more of a role, with the influence of non-clinical factors only diminishing once patients reached a cardiothoracic specialist. 39 Increased investment in catheter laboratories located in health boards with high levels of deprivation may also have had some effect on reducing socioeconomic inequity, along with falling thresholds in eligibility for revascularisation, since SES is associated with worse clinical prognosis after AMI.…”
Section: Possible Explanations and Implications Of Study Resultsmentioning
confidence: 99%