Percutaneous Coronary Intervention in the United States: Risk Factors for Untimely Access

Objective

To determine how access to percutaneous coronary intervention () is distributed across demographics.

Data Sources

Secondary data from the 2011 American Hospital Association () survey data combined with 2010 Census.

Study Design

We calculated prehospital times from 32,370 codes to the nearest center. We used a multivariate logit model to determine the odds of untimely access by the code's concentration of vulnerable populations.

Data Collection

We used code–level data on community characteristics from the 2010 Census and supplemented it with 2011 survey data on service‐line availability of for responding hospitals.

Principal Findings

For approximately 306 million Americans, the median prehospital time to the nearest center is 33 minutes. While 84 percent of Americans live within one hour of a center, the odds of untimely access are higher in low‐income (: 3.00; 95 percent : 2.39, 3.77), rural (8.10; 95 percent : 6.84, 9.59), and highly Hispanic communities (2.55; 95 percent : 1.86, 3.49).

Conclusions

While the majority of Americans live within 60 minutes of a center, rural, low‐income, and highly Hispanic communities have worse access. This may translate into worse outcomes for patients with acute myocardial infarction.