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Where you live doesn’t matter if you have heart disease, study finds

October 28, 2014 Toronto

People living in rural areas are at no greater risk of dying from heart disease than their urban counterparts, according to a new study by researchers at Women’s College Hospital and the Institute for Clinical Evaluative Sciences (ICES).

The study, the first to examine outpatient quality of care between urban and rural communities, counters existing research, which suggested gaps in care for those living in rural areas.

“Research has long suggested people with heart disease in rural areas are at a disadvantage when it comes to access to health care and longevity,” says Dr. Sacha Bhatia, lead author of the study and a cardiologist at Women’s College Hospital. “Our study shows once a patient leaves the hospital their overall health outcomes are similar regardless of where they live.”

The study, published today in Circulation: Cardiovascular Quality and Outcomes, examined the records of more than 38,000 people with chronic ischemic heart disease living in either urban or rural areas. They found, in comparison to their urban counterparts, those in rural areas:

  • Had fewer specialist visits
  • Visited hospital emergency departments more frequently for care
  • Were prescribed statins less often
  • Were tested less frequently for cholesterol and blood sugar levels
  • Experienced a similar risk of hospitalization and death

The researchers say while those living in rural areas access their care differently, it did not result in poor health outcomes.

“From our study, we know that people with heart disease in rural areas tend to rely heavily on emergency departments for their care because of a lack of outpatient access to family doctors and specialists,”  said Dr. Bhatia, also a scientist at ICES. “Yet, despite an increase in emergency department admissions in rural areas, we didn’t see worse health outcomes for these individuals.”

Women’s College Hospital (www.womenscollegehospital.ca) is advancing the health of women and improving healthcare options for all by delivering innovative models of ambulatory care. Fully affiliated with the University of Toronto, the hospital is Canada’s leading academic, ambulatory hospital and a world leader in women’s health. With more than 800 physicians, nurses and health professionals, the hospital offers a range of specialized clinics and programs that are bridging the gaps in the health system. Women’s College Hospital is helping to keep people out of hospital by being at the forefront of cutting-edge research, diagnosis and treatment that will help prevent illness and enable patients to manage their health conditions. This healthcare enables Canadians to live healthier, more independent lives. At the Women’s College Research Institute, scientists combine science and patient care to develop innovative solutions to today’s greatest health challenges.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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