Journal of Holistic Nursing and Midwifery (Jul 2014)
Comparison of ambulance use in urban and rural patients with Acute Myocardial Infarction
Abstract
Introduction: Acute Myocardial Infarction is a clinical condition for which delays in seeking care can have significant and adverse consequences on patients prognosis . Minimizing AMI treatment delays remains a priority for emergency medical services (EMS). Rural residents often have limited access to local health care providers and hospitals, which may affect their use of the ambulance. Comparison of ambulance use in urban and rural patients with AMI is essential for planning and appropriate EMS use. Objective: The aim of this study was to compare ambulance use between urban and rural patients with AMI in Guilan province. Methods: This cross-sectional survey was conducted on 162 consecutive patients with AMI (100 urban and 62 urban) admitted to Cardiac Care Unit (CCU) in Dr. Heshmat hospital in Rasht city 2011. Data were collected by using a four-part questionnaire (demographic, clinical, situational and cognitive) by interview. Data was analyzed by SPSS.V.16 using statistical tests (Chi-square, T test, logistic regression). Results: Findings indicated that (9.9%) urban and (7.4%) rural patients used ambulance but this difference was not significant (P<0.58). Regression analysis showed that older age (P<0.039, OR=1.95, CI=1.901-2.997), greater knowledge about prompt medical care seeking (P<0.003, OR=7.97, CI=2.02-31.44) were related to quicker seek for medical care ambulance transport in urban patients. Whilst, only greater knowledge was significantly related to quicker seek of medical care (P<0.005, OR=7.09, CI=1.79-28.02) of ambulance transport in rural patients. Conclusion: The results of present study showed that ambulance use did not differ based on place of residence in Guilan province. This may indicate this fact which community health care system in Iran is a universal and coordinate system and provides fair access to health care for all Iranians regardless of place of residence. Ambulance utilization may improve by providing public education.
