Patients who go to urban hospitals after having a heart attack receive more timely care than those at rural and urban non-interventional hospitals, new University of Otago research shows.
The study, published in the New Zealand Medical Journal, investigated whether there was a difference in the care given to patients who had a heart attack between January 2014 and December 2019 depending on the rural-urban category of the hospital they were first admitted to.
Three hospital categories were considered – large urban interventional, smaller urban non-interventional, and rural hospitals.
They were measured on whether patients received an angiography within three days, the assessment of left ventricular ejection fraction (LVEF) and the secondary prevention medication that was prescribed before discharge.
Of the 26,779 patients involved in the national study, 66.2% presented to urban interventional hospitals, 25.6% to urban non-interventional and 8.2% to rural hospitals.
Māori patients were more likely to go to urban non-interventional and rural hospitals than urban interventional.
Lead author Dr Rory Miller, of the Department of General Practice and Rural Health, said patients at rural or urban non-interventional hospitals experienced delays in receiving an angiography and were less likely to receive an echocardiography compared with patients who presented to urban interventional hospitals.
“The findings show people in our rural communities and smaller urban centres are potentially worse off than those in larger, urban settings,” Miller said.
“Māori patients are disproportionately impacted by delays in receiving angiography as they are more likely to live near rural or urban non-interventional hospitals.”
Māori and Pacific patients at urban interventional hospitals were less likely than non-Māori/non-Pacific to receive timely angiography, but more likely to have LVEF assessed.
However, LVEF assessment and timely angiography in urban non-interventional and rural hospitals were lower than in urban interventional hospitals for both Māori and non-Māori/non-Pacific.
The rates of prescribing secondary prevention medication at discharge were high and similar for all types of hospitals.