Geographic Variation in Mortality of Acute Myocardial Infarction and Association With Health Care Accessibility in Beijing, 2007 to 2018

• DOI: 10.1161/jaha.123.029769
• Publication Date: 2023-06-11T02:26:20Z
• Authors: Jie Chang; Qiuju Deng; Piaopiao Hu; Moning Guo; Feng Lu; Yuwei Su; Jiayi Sun; Yue Qi; Ying Long; Jing Liu
• Keywords: 1. No poverty; Myocardial Infarction; acute myocardial infarction; Bayes Theorem; 15. Life on land; geographic variation; mortality; Health Services Accessibility; 3. Good health; 13. Climate action; RC666-701; Beijing; 11. Sustainability; Diseases of the circulatory (Cardiovascular) system; Humans; Health Facilities; health care accessibility; Original Research

Background Little is known about geographic variation in acute myocardial infarction (AMI) mortality within fast-developing megacities and whether changes health care accessibility correspond to AMI at the small-area level. Methods Results We included data of 94 106 deaths during 2007 2018 from Beijing Cardiovascular Disease Surveillance System this ecological study. estimated for 307 townships consecutive 3-year periods with a Bayesian spatial model. Township-level was measured using an enhanced 2-step floating catchment area method. Linear regression models were used examine association between mortality. During 2018, median declined 86.3 (95% CI, 34.2-173.8) 49.4 30.5-73.7) per 100 000 population. The decrease larger where increased more rapidly. Geographic inequality, defined as ratio 90th 10th percentile townships, 3.4 3.8. In total, 86.3% (265/307) had increase accessibility. Each 10% associated -0.71% -1.08% -0.33%) change Conclusions disparities among are large increasing. A relative township-level Targeted improvement areas high may help reduce burden improve its inequality megacities.