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Geographical variation in a fatal outcome of acute myocardial infarction and association with contact to a general practitioner.pdf
Spatial and Spatio-temporal Epidemiology 19 (2016) 60–69
Contents lists available at ScienceDirect
Spatial and Spatio-temporal Epidemiology
journal homepage: /locate/sste
Geographical variation in a fatal outcome of acute myocardial infarction and association with contact to a general practitioner
Annette Kj?r Ersb?ll a,?, Thora Majlund Kj?rulff a, Kristine Bihrmann a, Jasper Schipperijn b, Gunnar Gislason a,c,d, Mogens Lytken Larsen e
a University of Southern Denmark, National Institute of Public Health, ?ster Farimagsgade 5A, DK-1353 Copenhagen, Denmark b University of Southern Denmark, Department of Sport Science and Clinical Biomechanics, Campusvej 55, DK-5230, Odense, Denmark c Department of Cardiology, Copenhagen University Hospital Gentofte, Kildegaardsvej 28 DK-2900 Hellerup, Denmark d The Danish Heart Foundation, Hauser Plads 10, DK-1127 Copenhagen, Demark e Danish Centre of Inequality in Health, Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, DK-9100 Aalborg, Denmark
article info
Article history: Received 15 November 2015 Revised 2 June 2016 Accepted 3 June 2016 Available online 11 June 2016
Keywords: Acute myocardial infarction Primary healthcare contact General practice SPDE INLA Gaussian ?eld
abstract
Background: Geographical variation in incidence and mortality of acute myocardial infarction (AMI) is present in Denmark. We aimed at examining the association between contact to a general practitioner (GP) the year before AMI and a fatal outcome of AMI. Methods: Register-based data and individual-level addresses including 69,608 individuals with AMI in 2006-2011. A Bayesian hierarchical logistic regression model was used to examine the association. Results: A fatal outcome of AMI was seen among 12.0% (78%) of individuals with (without) contact to a GP the year before AMI. A signi?cant association was estimated. Conclusions: A fatal outcome of AMI was signi?cantly associated with contact to a GP. A high population to GP ratio and lon
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