Neighborhood Variation in Rate of Revascularization among Acute Myocardial Infarction Patients in New York City

Objective. To identify modifiable neighborhood factors and quantify their effect on the rate of revascularization among acute myocardial infarction (AMI) patients. Method. Using the New York City hospital discharge records during 1998–2002, we employed a hierarchical regression model that integrates...

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Main Authors: Abdissa Negassa, Jing Fang
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Cardiology Research and Practice
Online Access:http://dx.doi.org/10.4061/2011/348527
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author Abdissa Negassa
Jing Fang
author_facet Abdissa Negassa
Jing Fang
author_sort Abdissa Negassa
collection DOAJ
description Objective. To identify modifiable neighborhood factors and quantify their effect on the rate of revascularization among acute myocardial infarction (AMI) patients. Method. Using the New York City hospital discharge records during 1998–2002, we employed a hierarchical regression model that integrates patient-level risk factors and neighborhood-level factors to retrospectively examine revascularization patterns among AMI patients. Results. Access to revascularization varied substantially (27%–88%) among neighborhoods. Ready access to a hospital with on-site capacity of revascularization increased the likelihood of receiving the procedure after adjusting for individual-level sociodemographic factors and comorbidity. More than 64% of the variation in rate of revascularization is explained by access to revascularization. Conclusion. Optimizing the AMI patients' delivery system to hospitals with on-site capacity of revascularization might enhance access to needed care thereby help to alleviate the prevailing variation in the rate of revascularization among New York City neighborhoods.
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spelling doaj-art-140d5d9ad4d643e2b5823def2d9da3892025-08-20T03:54:33ZengWileyCardiology Research and Practice2090-05972011-01-01201110.4061/2011/348527348527Neighborhood Variation in Rate of Revascularization among Acute Myocardial Infarction Patients in New York CityAbdissa Negassa0Jing Fang1Division of Biostatistics, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USADivision of Epidemiology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USAObjective. To identify modifiable neighborhood factors and quantify their effect on the rate of revascularization among acute myocardial infarction (AMI) patients. Method. Using the New York City hospital discharge records during 1998–2002, we employed a hierarchical regression model that integrates patient-level risk factors and neighborhood-level factors to retrospectively examine revascularization patterns among AMI patients. Results. Access to revascularization varied substantially (27%–88%) among neighborhoods. Ready access to a hospital with on-site capacity of revascularization increased the likelihood of receiving the procedure after adjusting for individual-level sociodemographic factors and comorbidity. More than 64% of the variation in rate of revascularization is explained by access to revascularization. Conclusion. Optimizing the AMI patients' delivery system to hospitals with on-site capacity of revascularization might enhance access to needed care thereby help to alleviate the prevailing variation in the rate of revascularization among New York City neighborhoods.http://dx.doi.org/10.4061/2011/348527
spellingShingle Abdissa Negassa
Jing Fang
Neighborhood Variation in Rate of Revascularization among Acute Myocardial Infarction Patients in New York City
Cardiology Research and Practice
title Neighborhood Variation in Rate of Revascularization among Acute Myocardial Infarction Patients in New York City
title_full Neighborhood Variation in Rate of Revascularization among Acute Myocardial Infarction Patients in New York City
title_fullStr Neighborhood Variation in Rate of Revascularization among Acute Myocardial Infarction Patients in New York City
title_full_unstemmed Neighborhood Variation in Rate of Revascularization among Acute Myocardial Infarction Patients in New York City
title_short Neighborhood Variation in Rate of Revascularization among Acute Myocardial Infarction Patients in New York City
title_sort neighborhood variation in rate of revascularization among acute myocardial infarction patients in new york city
url http://dx.doi.org/10.4061/2011/348527
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