Does community size or commute time affect severity of illness at diagnosis or quality of care in a centralized care model of pulmonary hypertension?

Autor: Brunner NW; Division of Cardiology, University of British Columbia, Vancouver, Canada. Electronic address: nathan.brunner@vch.ca., Legkaia L; Division of Respirology, University of British Columbia, Vancouver, Canada., Al-Ahmadi F; Division of Respirology, University of British Columbia, Vancouver, Canada., Lee L; Division of Respirology, University of British Columbia, Vancouver, Canada., Norena M; Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, Canada., Lam CSM; Division of Cardiology, University of British Columbia, Vancouver, Canada., Yim JJ; Division of Medicine, University of British Columbia, Vancouver, Canada., Luong C; Division of Cardiology, University of British Columbia, Vancouver, Canada., Weatherald J; Division of Respirology, University of Calgary, Calgary, Canada., Nador RG; Division of Respirology, University of British Columbia, Vancouver, Canada., Levy RD; Division of Respirology, University of British Columbia, Vancouver, Canada., Swiston JR; Division of Respirology, University of British Columbia, Vancouver, Canada.
Jazyk: angličtina
Zdroj: International journal of cardiology [Int J Cardiol] 2021 Jun 01; Vol. 332, pp. 175-181. Date of Electronic Publication: 2021 Mar 18.
DOI: 10.1016/j.ijcard.2021.03.035
Abstrakt: Background: Centralized care models are often used for rare diseases like pulmonary hypertension (PH). It is unknown how living in a rural or remote area influences outcomes.
Methods: We identified all patients from our PH database who carried a diagnosis of WHO Group 1 or WHO Group 4 PH. Using Canadian postal code data, patients were classified as living in a rural area; or a small, medium or large community size. The commute time from patient residence to our clinic was determined using mapping software. We compared baseline catheterization data according to community size and commute time. At follow up, we evaluated the association between community size and commute time with prognostic parameters of functional class, walk distance and echocardiography.
Results: Of the 342 patients identified, 72(21%) patients lived in rural areas, while 26(8%), 49(14%) and 195(57%) resided in small, medium and large population centres, respectively. The commute time was <1 h for 160(47%), 1-3 h for 62(18%), and >3 h for 120(35%). There was no association seen for any catheterization parameter by either community size or commute time. At last follow up, there was no association between any prognostic parameter and community size or commute time.
Conclusions: We found no association between community size or commute time with severity of illness at diagnosis, or markers of prognosis at follow up. This suggests that patients who reside in rural or remote environments are not experiencing deficiencies in care compared to urban patients.
Competing Interests: Declaration of Competing Interest All authors have no relevant conflicts of interest to declare.
(Copyright © 2021 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: