Patient delay and use of ambulance by patients with chest pain.
OBJECTIVE
To identify the reasons why patients with chest pain delay in seeking hospital medical care and do or do not use an ambulance.


METHODS
One hundred and fifty-one patients with an ED diagnosis of acute myocardial infarction or angina were interviewed about demographic characteristics, medical history, symptom onset, time taken before deciding to call an ambulance or go to hospital (delay time) and transport used. Multiple logistic regression determined independent predictors of late presentation (delay time>30 min) and ambulance use.


RESULTS
One hundred and twelve (74.2%, 95% CI 67.0-81.0%) patients delayed more than 30 min. Independent predictors of late presentation were: seeing a general practitioner (GP) (P=0.001), having prior heart problems (P=0.009) and symptoms occurring at night (P=0.036). Eighty-one (54.7%, 95% CI 47.0-63.0%) patients used an ambulance. Predictors of ambulance use were increased age (P=0.025) and having ambulance insurance (P=0.018), although there was interaction between these variables.


CONCLUSIONS
Education programmes should continue to emphasize that chest pain is a potential medical emergency and an ambulance should be called. GPs should consider developing an action plan to manage patients presenting with chest pain.
Ingarfield
Sharyn L
SL
Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, and Department of Emergency Medicine, Sir Charles Gairdner Hospital, Perth, Australia. ingars02@tartarus.uwa.edu.au
Jacobs
Ian G
IG
Jelinek
George A
GA
Mountain
David
D
D000552:Ambulances / Q000706:statistics & numerical data*; D000787:Angina Pectoris; D002637:Chest Pain; D003430:Cross-Sectional Studies; D003657:Decision Making; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D013997:Time Factors; D014904:Western Australia