Is there a difference in ischaemic heart disease deaths that occur without a preceding hospital admission in people who live in rural compared with urban areas of Aotearoa New Zealand? An observational study

被引：0

作者：

Miller, Rory ^{[1
,2
]}

Turner, Robin ^{[3
]}

Davie, Gabrielle ^{[4
]}

Stokes, Tim ^{[5
]}

Crengle, Sue ^{[4
]}

Mcleod, Alex ^{[6
]}

Tane, Taria ^{[7
]}

Nixon, Garry ^{[5
]}

机构：

[1] Univ Otago, Dunedin Campus, Dunedin, New Zealand

[2] Te Whatu Ora Hlth New Zealand Waikato, Thames, New Zealand

[3] Univ Otago, Dunedin Sch Med, Biostat, Dunedin, New Zealand

[4] Univ Otago, Prevent & Social Med, Dunedin, New Zealand

[5] Univ Otago, Gen Practice & Rural Hlth, Dunedin, New Zealand

[6] Coromandel Family Practice, Coromandel, New Zealand

[7] Univ Auckland, Fac Med & Hlth Sci, Populat Hlth, Auckland, New Zealand

来源：

BMJ OPEN | 2025年 / 15卷 / 02期

关键词：

Hospitals; Cardiovascular Disease; Mortality; Primary Prevention; PREVENTIVE MEDICINE; ACUTE CORONARY SYNDROMES; NATIONAL DATA-LINKAGE; CARDIAC-ARREST; PREHOSPITAL DEATHS; ETHNIC-DIFFERENCES; STATIN USE; OUTCOMES; MORTALITY; DEFIBRILLATION; INTERVENTION;

D O I：

10.1136/bmjopen-2024-088691

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives Unlike comparable countries, acute coronary syndrome (ACS) mortality is similar among patients who present to rural and urban hospitals in Aotearoa New Zealand (NZ). The aim of this study was to determine whether differences in ischaemic heart disease (IHD) deaths that occurred without a preceding hospital admission in rural and urban populations explained this finding.Design Retrospective observational study using the National Mortality Collection (MORT) and National Minimum Dataset (NMDS) for hospital discharges datasets.Setting People in NZ who died from IHD were categorised based on their rural-urban status (U1 (major urban), U2 (large urban) and rural) using the Geographic Classification for Health and prioritised ethnicity (M & amacr;ori-NZ's Indigenous population and non-M & amacr;ori).Participants All people 20+ years who died from IHD between July 2011 and December 2018.Primary and secondary outcomes The outcome was the lack of a hospital admission preceding IHD death, identified by linking the NMDS with MORT. This was measured for the 30 days and 1 year prior to death and for all-cause and IHD hospitalisations separately.Results Of the 37 296 deaths, a similar percentage of rural and urban residents died without an all-cause (rural 63.2%, U2 60.8%, U1 62.8%) or IHD (rural 70.9%, U2 69.0%, U1 70.1%) admission in the preceding 30 days, or without an all-cause (rural 32.8%, U2 35.5%, U1 35.5%) or IHD (rural 52.7%, U2 52.6%, U1 51.9%) admission in the preceding year. Exceptions were deaths that occurred without a prior admission for rural non-M & amacr;ori aged 55-64 (higher odds) and 75+ years (lower odds) compared with U1 non-M & amacr;ori 55-64 and 75+ years, respectively, across all four outcome measures.Conclusions This study suggests that the lack of difference in ACS mortality for patients who present to NZ rural and urban hospitals is not explained by IHD death that occurred without a recent preceding hospital admission.

引用

页数：13