ArticleBMJ open2016
Do acute myocardial infarction and stroke mortality vary by distance to hospitals in Switzerland? Results from the Swiss National Cohort Study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
- Spatiotemporal analysis of hospitalizations, mortality and access to intravenous thrombolysis for ischemic stroke in Southern Brazil.BMC public health · 2026Article
- Relationship of Distance to PCI Center With In-Hospital Mortality After STEMI: Insights From a Rural Regional STEMI Network.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
- Association between Acute Care Accessibility and in-Hospital Mortality among Patients with Acute Ischemic Stroke.JMA journal · 2025Article
- Spatial analysis of the impact of urban built environment on cardiovascular diseases: a case study in Xixiangtang, China.BMC public health · 2024Article
- Can we optimize locations of hospitals by minimizing the number of patients at risk?BMC health services research · 2023Article
- Access to mechanical thrombectomy and ischemic stroke mortality in Japan: a spatial ecological study.Frontiers in neurology · 2023Article
- Spatial-temporal analysis of cerebral infarction mortality in Hokkaido, Japan: an ecological study using a conditional autoregressive model.International journal of health geographics · 2022Article
- Home-to-hospital distance and outcomes among community-acquired sepsis hospitalizations.Annals of epidemiology · 2022Article
- Swiss Cohort & Biobank - The White Paper.Public health reviews · 2022Article
- Risk and space: modelling the accessibility of stroke centers using day- & nighttime population distribution and different transportation scenarios.International journal of health geographics · 2021Article
- Utilization of health care providers by individuals with chronic spinal cord injury.Spinal cord · 2021Article
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- How do patients enter the healthcare system after the first onset of multiple sclerosis symptoms? The influence of setting and physician specialty on speed of diagnosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2020Observational
- SMART-MEDS: Development of a Medication Adherence App for Acute Coronary Syndrome Patients based on a Gamified Behaviour Change Model.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2018Article
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveSwitzerland has mountains and valleys complicating the access to a hospital and critical care in case of emergencies. Treatment success for acute myocardial infarction (AMI) or stroke depends on timely treatment. We examined the relationship between distance to different hospital types and mortality from AMI or stroke in the Swiss National Cohort (SNC) Study. DESIGN AND
settingThe SNC is a longitudinal mortality study of the census 2000 population of Switzerland. For 4.5 million Swiss residents not living in a nursing home and older than 30 years in the year 2000, we calculated driving time and straight-line distance from their home to the nearest acute, acute with emergency room, central and university hospital (in total 173 hospitals). On the basis of quintiles, we used multivariable Cox proportional hazard models to estimate HRs of AMI and stroke mortality for driving time distance groups compared to the closest distance group.
resultsOver 8 years, 19 301 AMI and 21 931 stroke deaths occurred. Mean driving time to the nearest acute hospital was 6.5 min (29.7 min to a university hospital). For AMI mortality, driving time to a university hospital showed the strongest association among the four types of hospitals with a hazard ratio (HR) of 1.19 (95% CI 1.10 to 1.30) and 1.10 (95% CI 1.01 to 1.20) for men and women aged 65+ years when comparing the highest quintile with the lowest quintile of driving time. For stroke mortality, the association with university hospital driving time was less pronounced than for AMI mortality and did not show a clear incremental pattern with increasing driving time. There was no association with driving time to the nearest hospital.
conclusionsThe increasing AMI mortality with increasing driving time to the nearest university hospital but not to any nearest hospital reflects a complex interplay of many factors along the care pathway.
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