PMID- 17888181
OWN - NLM
STAT- MEDLINE
DCOM- 20080107
LR  - 20181201
IS  - 1476-072X (Electronic)
IS  - 1476-072X (Linking)
VI  - 6
DP  - 2007 Sep 23
TI  - Potential generation of geographical inequities by the introduction of primary 
      percutaneous coronary intervention for the management of ST segment elevation 
      myocardial infarction.
PG  - 43
AB  - BACKGROUND: Primary Percutaneous Coronary Intervention (PCI) is more efficacious 
      than thrombolysis in the management of acute myocardial infarction, but, because 
      of the requirement for prompt treatment, there are practical challenges in 
      developing such services. We examined the proportion of patients with ST segment 
      Elevation Myocardial Infarction (STEMI) who could receive timely treatment from a 
      primary Percutaneous Coronary Intervention (PCI) service assuming different 
      geographical locations of potential treatment centres in three English counties. 
      METHODS AND RESULTS: Information on the residential location of patients with new 
      STEMI hospitalisations recorded in Hospital Episodes Statistics was analysed and 
      the proportion of episodes of STEMI within 60' and 45' travel time isochrones 
      from potential primary PCI centres in three English counties was calculated. 
      There were on average 1,815 new STEMI hospitalisations per year occurring in the 
      studied population. Introduction of a primary PCI service in one, two or three 
      potential treatment centres would have covered respectively 28%, 73% and 90% of 
      such episodes within 60 minutes travel time, and 17%, 51% and 69% within 45 
      minutes travel time. CONCLUSION: In the study context, a primary PCI service in 
      an existing tertiary centre would only cover a minority of STEMI events and would 
      generate geographical inequities. A two-centre model would improve coverage and 
      equity considerably, but may be associated with practical, clinical quality and 
      financial challenges.
FAU - Pereira, Augustine
AU  - Pereira A
AD  - NHS East of England, Cambridge, UK. augustine.pereira@nhs.net
FAU - Niggebrugge, Aphrodite
AU  - Niggebrugge A
FAU - Powles, John
AU  - Powles J
FAU - Kanka, David
AU  - Kanka D
FAU - Lyratzopoulos, Georgios
AU  - Lyratzopoulos G
LA  - eng
PT  - Journal Article
DEP - 20070923
PL  - England
TA  - Int J Health Geogr
JT  - International journal of health geographics
JID - 101152198
SB  - IM
MH  - Angioplasty, Balloon, Coronary/standards/*statistics & numerical data
MH  - Cardiology Service, Hospital/statistics & numerical data
MH  - England
MH  - Geographic Information Systems
MH  - *Health Services Accessibility
MH  - *Healthcare Disparities
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Myocardial Infarction/*therapy
MH  - Practice Guidelines as Topic
MH  - Residence Characteristics
MH  - Time Factors
PMC - PMC2092423
EDAT- 2007/09/25 09:00
MHDA- 2008/01/08 09:00
PMCR- 2007/09/23
CRDT- 2007/09/25 09:00
PHST- 2007/06/01 00:00 [received]
PHST- 2007/09/23 00:00 [accepted]
PHST- 2007/09/25 09:00 [pubmed]
PHST- 2008/01/08 09:00 [medline]
PHST- 2007/09/25 09:00 [entrez]
PHST- 2007/09/23 00:00 [pmc-release]
AID - 1476-072X-6-43 [pii]
AID - 10.1186/1476-072X-6-43 [doi]
PST - epublish
SO  - Int J Health Geogr. 2007 Sep 23;6:43. doi: 10.1186/1476-072X-6-43.