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The proportion of South Africans living within 60 and 120 minutes for a percutaneous coronary intervention facility
Department of Clinical Research and Education, Karolinska Institute, Stockholm, Sweden; Division of Emergency Medicine, Stellenbosch University, Stellenbosch, South Africa.
Division of Emergency Medicine, Stellenbosch University, Stellenbosch, South Africa.
Department of Emergency Medical Care, University of Johannesburg, Johannesburg, South Africa.
Department of Clinical Research and Education, Karolinska Institute, Stockholm, Sweden; Department of Emergency Medicine and Services, Helsinki University, Helsinki, Finland.
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2018 (English)In: Cardiovascular Journal of Africa, ISSN 1995-1892, Vol. 29, no 1, p. 6-11Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Timely reperfusion, preferably via percutaneous coronary intervention (PCI) following myocardial infarction, improves mortality rates. Emergency medical services play a pivotal role in recognising and transporting patients with ST-elevation myocardial infarction directly to a PCI facility to avoid delays to reperfusion. Access to PCI is, in part, dependant on the geographic distribution of patients around PCI facilities. The aim of this study was to determine the proportion of South Africans living within 60 and 120 minutes of a PCI facility.

METHODS: PCI facility and population data were subjected to proximity analysis to determine the average drive times from municipal ward centroids to PCI facilities for each province in South Africa. Thereafter, the population of each ward living within 60 and 120 minutes of a PCI facility was extrapolated.

RESULTS: Approximately 53.8 and 71.53% of the South African population live within 60 and 120 minutes of a PCI facility. The median (IQR, range) drive times and distances to a PCI facility are 100 minutes (120.4 min, 0.7-751.8) across 123.6 km (157.6 km, 0.3-940.8).

CONCLUSION: Based on the proximity of South Africans to PCI facilities, it seems possible that most patients could receive timely PCI within 120 minutes of first medical contact. However, this may be unlikely for some due to a lack of medical insurance, under-developed referral networks or other system delays. Coronary care networks should be developed based on the proximity of communities to 12-lead ECG and reperfusion therapies (such as PCI facilities). Public and private healthcare partnerships should be fortified to allow for patients without medical insurance to have equal accesses to PCI facilities.

Place, publisher, year, edition, pages
Durbanville, South Africa: Clinics-Cardive Publishing Co. , 2018. Vol. 29, no 1, p. 6-11
Keywords [en]
myocardial infarction; healthcare disparities; percutaneous coronary intervention; South Africa
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-64444DOI: 10.5830/CVJA-2018-004ISI: 000428798500002PubMedID: 29582877Scopus ID: 2-s2.0-85043317271OAI: oai:DiVA.org:oru-64444DiVA, id: diva2:1176772
Available from: 2018-01-23 Created: 2018-01-23 Last updated: 2018-08-20Bibliographically approved

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