Primary percutaneous coronary intervention expansion to hospitals without on-site cardiac surgery in Michigan: A geographic information systems analysis - 08/08/11
, Eric R. Bates, MD a, Brahmajee K. Nallamothu, MD, MPH a, bRésumé |
Background |
In 2005, Michigan expanded primary percutaneous coronary intervention (P-PCI) capability to 12 hospitals without on-site cardiac surgery. We determined the potential impact of this expansion on geographic access to P-PCI for patients.
Methods |
Geographic information systems using the US Census Survey and hospital data from the state of Michigan were used to construct maps with 20-mile hospital service areas around P-PCI hospitals with and without on-site cardiac surgery. Geographic access was calculated as the percentage of the population living within the hospital service areas of these 2 types of hospitals.
Results |
Of 9938444 persons in Michigan, 7694834 (77.4%) lived within 20 miles of a P-PCI hospital. Thirty centers with on-site cardiac surgery provided access for 7219995 persons (72.6%). The 12 P-PCI hospitals without on-site cardiac surgery increased access by 474839 persons (4.8%). Of these, 3 geographically isolated facilities, which were at least 20 miles away from another P-PCI hospital, accounted for the greatest improvement in geographic access (n = 425700 [4.3%]), whereas the remaining 9 hospitals increased access by only 49139 persons (0.5%).
Conclusions |
Expansion of P-PCI to hospitals without on-site cardiac surgery in Michigan improved geographic access to a modest extent.
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Vol 155 - N° 4
P. 668-672 - avril 2008 Retour au numéro
Article précédent
- Simultaneous “hybrid” percutaneous coronary intervention and minimally invasive surgical bypass grafting: Feasibility, safety, and clinical outcomes
- Barry Reicher, Robert S. Poston, Mandeep R. Mehra, Ashish Joshi, Patrick Odonkor, Zachary Kon, Peter A. Reyes, David A. Zimrin
- Prognostic importance of creatine kinase and creatine kinase–MB after primary percutaneous coronary intervention for ST-elevation myocardial infarction
- Mark B. Nienhuis, Jan Paul Ottervanger, Menko-Jan de Boer, Jan-Henk E. Dambrink, Jan C.A. Hoorntje, A.T. Marcel Gosselink, Harry Suryapranata, Arnoud W.J. van't Hof, on behalf of the Zwolle Myocardial Infarction Study Group
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