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Heart Attack Care Often Delayed for the Poor
Date:9/22/2008

Reasons for slowed time to treatment remain unclear, experts say

MONDAY, Sept. 22 (HealthDay News) -- Poorer Americans, including those on Medicaid, are more likely to take much longer to get to the hospital when a heart attack strikes compared to more affluent people, a new study finds.

The finding suggests that patients without means may be at a greater risk of missing a critical window for time-sensitive care following a heart attack, the researchers noted.

"It's so important to get to the hospital quickly when a patient feels they are having symptoms of a heart attack," noted study lead author Randi E. Foraker, a doctoral candidate in the department of epidemiology at the University of North Carolina, Chapel Hill. "So it was particularly concerning to us that patients from lower socio-economic status areas, and patients covered by Medicaid insurance, experienced more of a pre-hospital delay in getting to a health facility."

Foraker and her team published their findings in the Sept. 22 issue of the Archives of Internal Medicine.

Their conclusions stem from an analysis of more than 6,700 medical records of men and women who experienced a heart attack between 1993 and 2002. By matching patient addresses to 2000 U.S. census data, the research team was able to establish household income levels as either low (less than $33,533), medium (between $33,533 and $50,031) or high (over $50,032).

Foraker and her colleagues determined that 36 percent of the patients faced a short delay (less than two hours) in reaching their local hospital. Another 42 percent experienced a medium delay of between two and 12 hours, while 22 percent underwent a long delay of between 12 hours and three days.

After accounting for such factors as age, gender, health insurance status, history of diabetes and/or high blood pressure, distance to hospital, and race, the study authors found that Medicaid patients a
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