Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015
|dc.identifier.citation||Forsyth, R. and Sun, Z. and Reid, C. and Moorin, R. 2021. Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015. Journal of Clinical Medicine. 10 (1): Article No. 49.|
Acute coronary syndrome (ACS) is globally recognised as a significant health burden, for which the reduction in total ischemic times by way of the most suitable reperfusion strategy has been the focus of national and international initiatives. In a setting such as western Australia, characterised by 79% of the population dwelling in the greater capital region, transfers to hospitals capable of percutaneous coronary intervention (PCI) is often a necessary but time-consuming reality for outer-metropolitan and rural patients.
Methods: Hospital separations, emergency department admissions and death registration data between 1 January 2007 and 31 December 2015 were linked by the Western Australian Data Linkage Unit, identifying patients with a confirmed first-time diagnosis of ACS, who were either a direct admission or experienced an inter-hospital transfer.
Results: Although the presentation rates of ACS remained stable over the nine years evaluated, the rates of first-time admissions for ACS were more than double in the rural residential cohort, including higher rates of ST-segment elevation myocardial infarction, the most time-critical manifestation of ACS. Consequently, rural patients were more likely to undergo an inter-hospital transfer. However, 42% of metropolitan admissions for a first-time ACS also experienced a transfer.
Conclusion: While the time burden of inter-hospital transfers for rural patients is a reality in health care systems where it is not feasible to have advanced facilities and workforce skills outside of large population centres, there is a concerning trend of inter-hospital transfers within the metropolitan region highlighting the need for further initiatives to streamline pre-hospital triage to ensure patients with symptoms indicative of ACS present to PCI-equipped hospitals.
|dc.subject||1102 - Cardiorespiratory Medicine And Haematology|
|dc.title||Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015|
|dcterms.source.title||Journal of Clinical Medicine|
© 2020 The Authors. Published by MDPI Publishing.
|curtin.department||School of Molecular and Life Sciences (MLS)|
|curtin.faculty||Faculty of Science and Engineering|
|curtin.contributor.orcid||Sun, Zhonghua [0000-0002-7538-4761]|
|curtin.contributor.orcid||Moorin, Rachael [0000-0001-8742-7151]|
|curtin.contributor.orcid||Reid, Christopher [0000-0001-9173-3944]|
|curtin.contributor.researcherid||Sun, Zhonghua [B-3125-2010]|
|curtin.contributor.scopusauthorid||Sun, Zhonghua |