Grant: Operating Grant

Heart attack survival rates vary dramatically in Ontario from 7% to 12% depending upon the health region in which one lives but the reasons for these variations are not known. One factor that may explain these differences is the availability of emergency primary angioplasty, using a balloon to open a blocked heart artery, which can only be done in 14 hospitals in Ontario. Emergency angioplasty is a more effective treatment than clot-busting drugs in improving heart-attack survival rates but clot-busting drugs have the advantage that they can be given in any emergency room. Recently, doctors have been trying new strategies in some regions of Ontario whereby they arrange for paramedics to transfer heart attack patients by ambulance to the nearest angioplasty hospital to get emergency treatment rather treating the patients with clot-busting drugs at their local hospital. However, it is uncertain if health regions that transfer patients for emergency angioplasty have better heart attack survival rates than regions where patients are treated at their local hospital. In this project, we will determine the patient, treatment, and health system-related factors that explain variations in heart attack survival for 6,000 patients treated during 2008 to 2010 across Ontario's 14 health regions. We will develop 'report cards' on the quality of care that heart attack patients received in each region in Ontario, and identify opportunities by which various health regions in Ontario, can improve their treatment and survival rates for heart attack patients. We will share our findings with government, hospitals, and clinicians who treat these patients, so that the system can improve and reduce the number of patients who die from a heart attack. We estimate that it may be possible to save up to 600 lives each year in Ontario, if all health regions could achieve the best heart attack survival rates currently observed in Ontario.