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• W2893688935 abstract "Previous studies have demonstrated the harmful effect of remote geographic place of residence on access to cardiac catheterization across Canada. However, little is known regarding the impact of these disparities in access to cardiac catheterization on long-term clinical outcomes. The purpose of this study was to examine the effect of geographic factors on access to and long-term outcomes following cardiac catheterization in New Brunswick. All patients undergoing inpatient and outpatient cardiac catheterization between January 2006 and June 2011 at the New Brunswick Heart Centre (NBHC), the sole tertiary cardiac care facility for all of New Brunswick, were identified. Follow up was available through March 2014. A patient’s geographic place of residence was defined as the driving distance from the patient’s home to the NBHC and was categorized as follows: 0-50km, 50-100km, 100-150km, 150-200km, and >200km. Access to cardiac catheterization was defined as wait time from the date of referral to the date of procedure, while the long-term outcome of interest was a composite of all-cause mortality, readmission for any cardiac cause, and repeat cardiac procedure. The impact of distance on access to and long-term outcomes following cardiac catheterization was determined using multiple linear regression and Cox proportional hazards modeling, respectively, adjusted for differences in age, sex, marital status, preferred language (French vs. English/unknown), socioeconomic status as defined by social and material deprivation index, urban vs. rural area of residence, and distance to closest hospital offering 24/7 emergency care. Analyses were carried out separately for inpatient and outpatient procedures. 17,397 patients formed the final study population (inpatient: n=10,530; outpatient: n=6,867). The median length of follow-up was 1156 days for inpatients and 1203 days for outpatients. Following risk adjustment, patients who lived farthest from the NBHC were most likely to experience the longest wait times for cardiac catheterization, whether it was as an inpatient or as an outpatient (Table 1). However, distance did not emerge as an independent predictor of the composite long-term outcome of interest for either group (Table 1). While increased distance from the tertiary care facility was found to be independently associated with longer wait times for cardiac catheterization in New Brunswick, it had no effect on long-term adverse outcomes. This suggests that geographic place of residence, and by extension prolonged wait times, are of minimal long-term clinical consequence in patients undergoing cardiac catheterization." @default.
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• W2893688935 date "2018-10-01" @default.
• W2893688935 modified "2023-09-25" @default.
• W2893688935 title "INCREASED DISTANCE FROM THE TERTIARY CARDIAC CARE CENTRE PROLONGS WAIT TIMES BUT DOES NOT AFFECT LONG-TERM OUTCOMES IN PATIENTS UNDERGOING CARDIAC CATHETERIZATION IN NEW BRUNSWICK" @default.
• W2893688935 doi "https://doi.org/10.1016/j.cjca.2018.07.146" @default.
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