Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015

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...

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Main Authors: Forsyth, René, Sun, Zhonghua, Reid, Christopher, Moorin, Rachael
Format: Journal Article
Published: MDPI AG 2021
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/82225
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author Forsyth, René
Sun, Zhonghua
Reid, Christopher
Moorin, Rachael
author_facet Forsyth, René
Sun, Zhonghua
Reid, Christopher
Moorin, Rachael
author_sort Forsyth, René
building Curtin Institutional Repository
collection Online Access
description 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.
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spelling curtin-20.500.11937-822252021-01-13T04:02:59Z Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015 Forsyth, René Sun, Zhonghua Reid, Christopher Moorin, Rachael 1102 - Cardiorespiratory Medicine And Haematology 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. 2021 Journal Article http://hdl.handle.net/20.500.11937/82225 10.3390/jcm10010049 http://creativecommons.org/licenses/by/4.0/ MDPI AG fulltext
spellingShingle 1102 - Cardiorespiratory Medicine And Haematology
Forsyth, René
Sun, Zhonghua
Reid, Christopher
Moorin, Rachael
Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015
title Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015
title_full Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015
title_fullStr Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015
title_full_unstemmed Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015
title_short Rates and Patterns of First-Time Admissions for Acute Coronary Syndromes across Western Australia Using Linked Administrative Health Data 2007–2015
title_sort rates and patterns of first-time admissions for acute coronary syndromes across western australia using linked administrative health data 2007–2015
topic 1102 - Cardiorespiratory Medicine And Haematology
url http://hdl.handle.net/20.500.11937/82225