Association between Residence Location and Pre-Hospital Delay in Patients with Heart Failure

Kyoung Suk Lee, Hyeongsuk Lee and Jae-Hyeong Park
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Kyoung Suk Lee: Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, The Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea
Hyeongsuk Lee: College of Nursing, Gachon University, Incheon 21936, Korea
Jae-Hyeong Park: Department of Internal Medicine, Chungnam National University Hospital, School of Medicine, Chungnam National University, Daejeon 35015, Korea

IJERPH, 2021, vol. 18, issue 12, 1-10

Abstract: Rural residents with heart failure (HF) face more challenges than their urban counterparts in taking action when their symptoms worsen due to limited healthcare resources in rural areas. This may contribute to rural residents’ pre-hospital delay in seeking medical care. However, few studies have investigated the relationship between residence locations and pre-hospital delay among patients with HF. Therefore, this study determined whether living in rural areas is associated with pre-hospital delay in patients with HF. A retrospective electronic medical record review was conducted using the data of patients discharged with worsening HF from an academic medical center. Data on postal codes of the patients’ residences and their experiences before seeking medical care were obtained. Pre-hospital delay was calculated from the onset of HF symptoms to hospital arrival. A multivariate linear regression analysis was performed to determine the relationship between residence location and pre-hospital delay. The median pre-hospital delay time of all patients was 72 h (N = 253). About half of the patients did nothing to relieve their symptoms before seeking medical care. Living in urban areas was associated with a shorter pre-hospital delay. Patients with HF waited several days after first experiencing worsening of symptoms before getting admitted to a hospital, which may be related to inappropriate interpretation and responses to the worsening of symptoms. Furthermore, we found that rural residents were more vulnerable to pre-hospital delay than their urban counterparts.

Keywords: heart failure; rural population; care seeking; symptom experience (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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