วันอังคารที่ 23 กันยายน พ.ศ. 2551

Poorer Americans Less Likely to Get Timely Heart Attack Care


by Jyoti Pal

According to a latest research, poorer Americans as well as those covered through Medicaid are less likely to get timely treatment in case they suffer a heart attack, in comparison to those who are wealthier or have a better insurance coverage than that offered by Medicaid.

Residents of lower-income neighborhoods – those with annual income less than $33,533 – were more likely to reach the hospital after a longer delay than the recommended time span of ‘within two hours of heart attack symptoms’, a new research published in the latest issue of the journal Archives of Internal Medicine touted.

The Atherosclerosis Risk in Communities (ARIC) study analyzed medical records of more than 6,700 men and women who had heart attacks between 1993 and 2002. Their residential addresses were then matched with social and economic data from the 2000 U.S. Census.

Based on links established, the researchers broadly classified household income levels as either; low (less than $33,533); medium (between $33,533 and $50,031); and high (over $50,032). Furthermore, the delays in reaching hospital were broken into three categories: short delay (less than 2 hours); medium delay (2-12 hours); and long delay (12 to 72 hours).

Data analysis revealed that while 36 percent of the patients reached the hospital within two hours of developing heart attack symptoms (short delay), nearly 42 percent experienced a medium delay (2-12 hours) and 22 percent experienced a delay longer than 12 hours.

A deeper investigation highlighted that although the low income patients were more likely to live closer to the hospitals than persons in the high income strata, they were still more likely to have a long (more than 12 hours) or moderate (two hours to 12 hours) delay in seeking the life-saving treatment.

"Low neighborhood household income was associated with higher odds of long vs. short delay and medium vs. short delay compared with high neighborhood household income in a model including age, sex, race and study community" noted, Randi Foraker, lead author of the study and a predoctoral fellow at the University of North Carolina at Chapel Hill.

Moreover comparing patients covered by Medicaid with those insured by other prepaid insurance plans, Medicaid patients were more likely to experience medium and long treatment delays, the researchers found.

Meanwhile, the study fails to examine why heart attack patients in lower-income range and those covered by Medicaid face a slower response time to get to hospitals.

Emphasizing on the fact that ‘timing of treatment’ is crucial in heart attack patients to avoid further muscle damage, Foraker said, "awareness campaigns should be targeted in lower-income areas and for those using Medicaid."

ไม่มีความคิดเห็น: