Abstract

Evaluating geographic access to cardiac catheterization in Canada
Track: Health and Human Services
Authors: Alka Patel, Jack Tu, Stéphane Rinfret, Dennis Ko, Nigel Waters, Mark Eisenberg, Thao Huynh, Merril Knudtson, William Ghali

This project seeks to improve care for patients experiencing acute myocardial infarctions (AMI: heart attacks) by determining geographic areas and populations with access to percutaneous coronary interventions (PCI) within clinical time constraints (60-minutes). ArcGIS 9.2 was used to estimate pre-hospital times by ground to PCI facilities across Canada. Travel along the road network was evaluated and time to dispatch, time to patient and time at patient scene were considered in the overall access times. The effect of adding hypothetical new PCI facilities on timely population access was examined. Only a small proportion of Canada's geographic surface area is accessible to PCI facilities within this timeframe. Despite this, Canada's adult population distribution (=40 years) is such that 63.9% of the population can access PCI within 60 minutes. The proportion with such access varies widely across provinces. Such information can be used to inform the development of regionalized AMI care models.

Alka Patel
University of Calgary, Department of Community Health Sciences
Health Sciences Centre
3330 Hospital Drive NW
Calgary, Alberta T2N 4N1
Canada
Phone: 403-608-7920
E-mail: alpatel@ucalgary.ca

Jack Tu
ICES
G1 06, 2075 Bayview Avenue
Toronto, Ontario M4N 3M5
Canada
Phone: 416-480-4700
E-mail: tu@ices.on.ca

Stéphane Rinfret
Laval University
2325, rue de l'Université
Québec, Québec G1V 0A6
Canada
Phone: 418 656-2131
E-mail: stephane.rinfret@criucpq.ulaval.ca

Dennis Ko
ICES
G1 06, 2075 Bayview Avenue
Toronto, Ontario M4N 3M5
Canada
Phone: 416-480-6100
E-mail: dennis.ko@ices.on.ca

Nigel Waters
George Mason University
4400 University Drive, MS 6C3
Fairfax, Virginia 22030-4444
United States
Phone: (703) 993-4687
E-mail: nwaters@gmu.edu

Mark Eisenberg
McGill University Health Center
Jewish General Hospital/McGill University
3755 Ch de la Côte-Sainte-Catherine Suite A-118
Montréal, Québec H3T 1E2
Canada
Phone: 514-340-8222
E-mail: mark.eisenberg@mcgill.ca

Thao Huynh
McGill University Health Center
2155 Guy Street, 5th Floor
Montréal, Québec H3H 2R9
Canada
Phone: 514-934-1934
E-mail: thao.huynhthanh@mail.mcgill.ca

Merril Knudtson
University of Calgary
3330 Hospital Drive NW
Calgary, Alberta T2N 4N1
Canada
Phone: 403.944.3282
E-mail: mlknudts@ucalgary.ca

William Ghali
University of Calgary
3330 Hospital Drive NW
Calgary, Alberta T2N 4N1
Canada
Phone: 403-210-9317
E-mail: wghali@ucalgary.ca