title: Utilization of emergency medical services for symptoms of acute myocardial infarction.
abstract: OBJECTIVE
  To examine patient characteristics and situational and clinical factors that affect utilization of Emergency Medical Services (EMS) for symptoms of acute myocardial infarction (AMI).
  
  
  METHODS
  Telephone interview of patients hospitalized with suspected AMI.
  
  
  METHODS
  Nine hospitals in King County, Washington.
  
  
  METHODS
  Patients admitted to a coronary or intensive care unit between October 1, 1986, and December 31, 1987, with suspected AMI occurring out of hospital. Spouses of patients who met criteria but died during the hospitalization also participated.
  
  
  METHODS
  Patient demographics, coping strategies, situational factors, prior cardiac history, perceived symptom severity, belief about the nature of condition, and method of transportation.
  
  
  RESULTS
  Descriptive statistics showed that although few patients called EMS as a "first thing" in response to symptoms, almost half of all patients called EMS before being hospitalized. Stepwise logistic regression analyses revealed that being older, the belief that one was experiencing a heart attack, the presence of other people (including the spouse), and the lack of physical activity at time of symptom onset, were related to both greater and quicker utilization of EMS. Additionally, education, medical history of angina, and severity of symptoms also were related to utilization of EMS.
  
  
  CONCLUSIONS
  The findings are discussed in a theoretical context, using Leventhal's self-regulatory model to suggest avenues for future research and interventions.
authors.affiliation: Seattle-King County Department of Public Health, Center for Evaluation of Emergency Medical Services, WA 98164, USA.
authors.forename: H
authors.initials: H
authors.lastname: Meischke
authors.forename: M S
authors.initials: MS
authors.lastname: Eisenberg
authors.forename: S M
authors.initials: SM
authors.lastname: Schaeffer
authors.forename: S K
authors.initials: SK
authors.lastname: Damon
authors.forename: M P
authors.initials: MP
authors.lastname: Larsen
authors.forename: D K
authors.initials: DK
authors.lastname: Henwood
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004522:Educational Status; D004631:Emergency Medical Service Communication Systems / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D014861:Washington