Background & Objective: In Taiwan, approximate 150 thousand people die of Coronary heart disease (CHD) in 2009. Coronary heart disease (CHD) became the second leading cause of death in Taiwan. The mortality rate of CHD was only lower than cancer disease. The patients who have AMI but do not receive adequate treatment in time have a higher ratio of sudden death. This study would like to analyze the differences in survival of emergency department(ED) patients with acute myocardial infarction (AMI) between urban and rural residents.
Methods: National Health Insurance (NHI) medical claim data from the cohort of 1,000,000 samples representing 23 million insured people during 1997 to 2008 were used to analyze the survival of ED patients with AMI. This study adopts seven levels of classification for urbanization as the differences between urban and rural areas. The frequency and percentage were used to describe the distribution of the variables. Finally, this study performed logistic regression analysis to examine the factors which influence the survival of ED patients with AMI.
Results: Among 2701 ED patients with AMI, the average age is 65.1. Areas located in the 1st-2nd levels of urbanization have 54.6% of patients and areas located in the 6th-7th levels have 10.9%. The mortality rate is 13.4%. The factors associated with the survival of ED patients with AMI included patients’ age, catastrophic illness, cerebrovascular disease, renal disease, AMI treated in ED before, 3-day admission, institution ownership, institutions’ geographic location of NHI, emergency service volume, and practice years of physician. However, the geographic location of urbanization and sex of patient are not significantly influential factors for the death of ED patients with AMI.
Conclusion: Health status and characteristics of health providers are the important factors of survival of ED patients with AMI. However, there is no significant difference in survival of ED patients with AMI between urban and rural residents.
