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Title: Management of the acute cardiac patient in the Australian rural setting: a 12 month retrospective study.
Austin Authors: Clune, Samantha J;Blackford, Jeanine;Murphy, Maria
Affiliation: La Trobe Rural Health School, La Trobe University, Wodonga 3689, Australia
School of Nursing & Midwifery, La Trobe University, Bundoora 3086, Australia
La Trobe University Clinical School of Nursing @ Austin Health, Heidelberg 3084, Australia
Issue Date: 6-Apr-2013
Publication information: Australian Critical Care 2013; 27(1): 11-6
Abstract: Rural cardiac patients may require transfer to tertiary health services for ongoing acute cardiac management. The time required to transfer is a consideration in determining appropriate clinical care. There is little published data reporting acute cardiac management in the Australian regional setting that reviews factors determining transfer to a tertiary centre.This paper reports the findings of a quantitative, retrospective study conducted to identify demographic differences and potential predictors to urban transfer for ongoing acute cardiac management for patients presenting to a regional hospital with suspected acute myocardial infarction.Using a purpose designed tool an audit of 204 files from June 2009 to July 2010 was conducted for all patients admitted to a regional hospital having a discharge diagnosis of acute myocardial infarction or angina. Patient demographics, clinical outcomes, concordance with treatment guidelines, and possible predictors of treatment decisions were investigated.Patients younger than 65 years (p<0.001), unemployed (p<0.01) and with acute electrocardiograph changes (p<0.01) were more likely to be transferred to a tertiary centre. Treatment guidelines concordance for acute cardiac care ranged from 70% to 79% for all patients.Although presenting patients were treated in a timely manner consistent with national guidelines, to be younger, unemployed or have electrocardiograph changes was a greater predictor to urban transfer. It is unknown if these differences in transferring or not to a tertiary centre contribute to poorer long-term cardiac outcomes for rural patients. Further evaluations are warranted.
Gov't Doc #: 23566923
DOI: 10.1016/j.aucc.2013.03.002
Type: Journal Article
Subjects: Myocardial infarction
Rural health
Hospitals, Community
Myocardial Infarction.therapy
Patient Transfer.statistics & numerical data
Retrospective Studies
Rural Health
Rural Health Services
Tertiary Care Centers
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