Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac Event: The Cardiac ARIA Project


Autoria(s): Clark, Robyn.; Coffee, Neil.; Turner, Dorothy.; Eckert, Kerena. A.; van Gaans, Deborah.; Wilkinson, David.; Stewart, Simon.; Tonkin, Andrew. M.
Data(s)

2012

Resumo

Background: Access to cardiac services is essential for appropriate implementation of evidence-based therapies to improve outcomes. The Cardiac Accessibility and Remoteness Index for Australia (Cardiac ARIA) aimed to derive an objective, geographic measure reflecting access to cardiac services. Methods: An expert panel defined an evidence-based clinical pathway. Using Geographic Information Systems (GIS), a numeric/alpha index was developed at two points along the continuum of care. The acute category (numeric) measured the time from the emergency call to arrival at an appropriate medical facility via road ambulance. The aftercare category (alpha) measured access to four basic services (family doctor, pharmacy, cardiac rehabilitation, and pathology services) when a patient returned to their community. Results: The numeric index ranged from 1 (access to principle referral center with cardiac catheterization service ≤ 1 hour) to 8 (no ambulance service, > 3 hours to medical facility, air transport required). The alphabetic index ranged from A (all 4 services available within 1 hour drive-time) to E (no services available within 1 hour). 13.9 million (71%) Australians resided within Cardiac ARIA 1A locations (hospital with cardiac catheterization laboratory and all aftercare within 1 hour). Those outside Cardiac 1A were over-represented by people aged over 65 years (32%) and Indigenous people (60%). Conclusion: The Cardiac ARIA index demonstrated substantial inequity in access to cardiac services in Australia. This methodology can be used to inform cardiology health service planning and the methodology could be applied to other common disease states within other regions of the world.

Formato

application/pdf

Identificador

http://eprints.qut.edu.au/49161/

Publicador

Lippincott Williams & Wilkins

Relação

http://eprints.qut.edu.au/49161/3/Application_of_Geographic_Modeling_Techniques_to_Quantify_Spatial_Access_to_Health_Services_Before_and_After_an_Acute_Cardiac_Event.pdf

DOI:10.1161/CIRCULATIONAHA.111.083394

Clark, Robyn., Coffee, Neil., Turner, Dorothy., Eckert, Kerena. A., van Gaans, Deborah., Wilkinson, David., Stewart, Simon., & Tonkin, Andrew. M. (2012) Application of Geographic Modeling Techniques to Quantify Spatial Access to Health Services Before and After an Acute Cardiac Event: The Cardiac ARIA Project. Circulation, 125(16), pp. 2006-2014.

http://purl.org/au-research/grants/NHMRC/570141

Direitos

Copyright 2012 Lippincott Williams & Wilkins

Fonte

Faculty of Health; Institute of Health and Biomedical Innovation; School of Nursing

Palavras-Chave #110000 MEDICAL AND HEALTH SCIENCES #110200 CARDIOVASCULAR MEDICINE AND HAEMATOLOGY #110201 Cardiology (incl. Cardiovascular Diseases) #110299 Cardiovascular Medicine and Haematology not elsewhere classified #111000 NURSING #111700 PUBLIC HEALTH AND HEALTH SERVICES #111799 Public Health and Health Services not elsewhere classified #Cardiac #Healthcare services #Geographic Information Systems (GIS) #Access
Tipo

Journal Article