TY - JOUR
T1 - Association between accessibility to emergency cardiovascular centers and cardiovascular mortality in Japan
AU - J-PULSE III Investigators
AU - Kada, Akiko
AU - Yonemoto, Naohiro
AU - Yokoyama, Hiroyuki
AU - Nonogi, Hiroshi
AU - Hanada, Hironori
AU - Hase, Mamoru
AU - Sakamoto, Tetsuya
AU - Kasaoka, Syunji
AU - Kikuti, Migaku
AU - Nagao, Ken
AU - Sase, Kazuhiro
AU - Kimura, Kazuo
AU - Sumiyoshi, Tetsuya
AU - Fujimoto, Kazuteru
AU - Hisao, Ogawa
AU - Shirai, Shinichi
N1 - Publisher Copyright:
© The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Objective: The aim of this study was to examine the association between accessibility to cardiovascular emergency centers and cardiovascular mortality in Japan. Design: A semi-ecological study. Setting: Three databases were generated: accessibility to emergency cardiovascular centers, population records and death records. Main Outcome Measures: The standardized mortality ratio (SMR) for cardiovascular disease was adjusted by age and sex. Accessibility was represented by transfer time, number of cardiovascular emergency hospitals, and the proportion of habitable areas. Combinations of the three were divided into Categories 1-8 from the worst to the best, and the association with SMR was analyzed. Results: There were 1998 cardiovascular emergency hospitals. The median of crude mortality was 0.16%. The median SMR of the reference Category 8 (transfer time <30 min and habitable area ≥50% with cardiovascular emergency hospitals) was 0.96, but that of the low accessibility Category 1 (transfer time ≥30 min and habitable area <50% without cardiovascular emergency hospitals) was 1.10. The SMR of accessibility Category 1: Category 8 was 1.18 (95% confidence interval: 1.14-1.21). Conclusions: Decreased accessibility to cardiovascular emergency hospitals was associated with increased SMR. Areas with less accessibility and higher cardiovascular mortality were characterized by geographical variability in Japan.
AB - Objective: The aim of this study was to examine the association between accessibility to cardiovascular emergency centers and cardiovascular mortality in Japan. Design: A semi-ecological study. Setting: Three databases were generated: accessibility to emergency cardiovascular centers, population records and death records. Main Outcome Measures: The standardized mortality ratio (SMR) for cardiovascular disease was adjusted by age and sex. Accessibility was represented by transfer time, number of cardiovascular emergency hospitals, and the proportion of habitable areas. Combinations of the three were divided into Categories 1-8 from the worst to the best, and the association with SMR was analyzed. Results: There were 1998 cardiovascular emergency hospitals. The median of crude mortality was 0.16%. The median SMR of the reference Category 8 (transfer time <30 min and habitable area ≥50% with cardiovascular emergency hospitals) was 0.96, but that of the low accessibility Category 1 (transfer time ≥30 min and habitable area <50% without cardiovascular emergency hospitals) was 1.10. The SMR of accessibility Category 1: Category 8 was 1.18 (95% confidence interval: 1.14-1.21). Conclusions: Decreased accessibility to cardiovascular emergency hospitals was associated with increased SMR. Areas with less accessibility and higher cardiovascular mortality were characterized by geographical variability in Japan.
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U2 - 10.1093/intqhc/mzw019
DO - 10.1093/intqhc/mzw019
M3 - Article
C2 - 26921258
AN - SCOPUS:84991327533
SN - 1353-4505
VL - 28
SP - 281
EP - 287
JO - International Journal for Quality in Health Care
JF - International Journal for Quality in Health Care
IS - 3
ER -
