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

ObjectivesUnlike 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 p...

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Veröffentlicht in:BMJ open Jg. 15; H. 2; S. e088691
Hauptverfasser: Miller, Rory, Turner, Robin, Davie, Gabrielle, Stokes, Tim, Crengle, Sue, Mcleod, Alex, Tane, Taria, Nixon, Garry
Format: Journal Article
Sprache:Englisch
Veröffentlicht: England British Medical Journal Publishing Group 27.02.2025
BMJ Publishing Group LTD
BMJ Publishing Group
Schlagworte:
Adult
Aged
Aged, 80 and over
Cardiovascular Disease
Cardiovascular Medicine
Classification
Datasets
Ethnicity
Female
Health disparities
Hospitalization
Hospitalization - statistics & numerical data
Hospitals
Humans
Ischemia
Male
Middle Aged
Mortality
Myocardial Ischemia - ethnology
Myocardial Ischemia - mortality
New Zealand - epidemiology
Observational studies
Original Research
Patient admissions
PREVENTIVE MEDICINE
Primary Prevention
Retrospective Studies
Rural areas
Rural Population - statistics & numerical data
Urban areas
Urban health care
Urban Population - statistics & numerical data
New Zealand
Cardiovascular Disease
PREVENTIVE MEDICINE
Primary Prevention
Hospitals
Mortality
ISSN:2044-6055, 2044-6055
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Zusammenfassung:ObjectivesUnlike 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.DesignRetrospective observational study using the National Mortality Collection (MORT) and National Minimum Dataset (NMDS) for hospital discharges datasets.SettingPeople 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 (Māori—NZ’s Indigenous population and non-Māori).ParticipantsAll people 20+ years who died from IHD between July 2011 and December 2018.Primary and secondary outcomesThe 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.ResultsOf 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-Māori aged 55–64 (higher odds) and 75+ years (lower odds) compared with U1 non-Māori 55–64 and 75+ years, respectively, across all four outcome measures.ConclusionsThis 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.
Bibliographie:Original research
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None declared.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2024-088691