New University of Otago research has found people in rural communities and smaller urban centres are potentially worse off than those in larger settings, who are 29% more likely than their rural counterparts to have an angiography within three days .
Lead author and University of Otago general practice and rural health department researcher Dr Rory Miller said those who went to urban hospitals after having a heart attack received more timely care than those at rural and urban non-interventional hospitals.
The study investigated if there was a difference in the care given to patients who had a heart attack between January 2014 and December 2019, depending on the rural-urban category of the hospital they were first admitted to.
Three hospital categories were considered — large urban interventional, smaller urban non-interventional and rural hospitals.
They were measured on whether patients received an angiography within three days, the assessment of left ventricular ejection fraction (LVEF) and prescription of secondary prevention medication that was prescribed before discharge.
Of the 26,779 patients involved in the national study, 66.2% presented to urban interventional hospitals, 25.6% to urban non-interventional and 8.2% to rural hospitals.
Māori patients were more likely to go to urban non-interventional and rural hospitals than urban interventional.
Dr Miller said patients at rural or urban non-interventional hospitals experienced delays in receiving an angiography and were less likely to receive an echocardiography, compared with patients who presented to urban interventional hospitals.
The research found 72.7% of patients overall received an angiography within three days.
At urban interventional hospitals the figure was was 78.5%, but at rural hospitals, the figure was 60.8%, and at urban non-interventional hospitals it was 63.8%.
"The findings show people in our rural communities and smaller urban centres are potentially worse off than those in larger, urban settings.
"Māori patients are disproportionately impacted by delays in receiving angiography as they are more likely to live near rural or urban non-interventional hospitals."
He said the study also found Māori and Pacific patients at urban interventional hospitals were less likely than non-Māori/non-Pacific to receive timely angiography, but more likely to have LVEF assessed.
For patients presenting to urban interventional hospitals, 74.3% of Māori patients and 69.3% of Pacific patients, received this investigation compared 79.8% of non-Māori, non-Pacific patients.
However, LVEF assessment and timely angiography in urban non-interventional and rural hospitals were lower than in urban interventional hospitals for both Māori and non-Māori/non-Pacific.
The rates of prescribing for secondary prevention medication at discharge were high and similar for all types of hospitals, he said.
