title: Is it possible to distribute a scarce resource equitably? Access to invasive procedures for patients with acute myocardial infarction.
abstract: OBJECTIVE
  To compare waiting times for inpatient cardiac catheterisation between a hospital with on-site cardiac catheterisation facility (Auckland City Hospital, ACH) and one of its referring hospitals (North Shore Hospital, NSH).
  
  
  METHODS
  Patients were included if they were admitted ACH or NSH with a myocardial infarction, and subsequently underwent inpatient coronary angiography.
  
  
  RESULTS
  853 patients were identified from NSH and 600 from ACH. Patients from NSH waited significantly longer for coronary angiography (median delay 6 versus 3 days, p<0.0009) and fewer underwent this procedure within 48 hours of admission (11% versus 36%, p<0.0009). Delays in percutaneous coronary intervention were significantly longer for NSH patients (6 versus 3 days, p<0.0009), and fewer NSH patients underwent this procedure within 48 hours (12% versus 41%, p<0.0009).
  
  
  CONCLUSIONS
  Inpatients with myocardial infarction waited longer for coronary angiography and percutaneous coronary intervention at a hospital without invasive facility than similar patients at the regional referral hospital with on-site invasive facility.
authors.affiliation: Whakatane Hospital, Whakatane.
authors.forename: Phillip
authors.initials: P
authors.lastname: Insull
authors.forename: Ritwik
authors.initials: R
authors.lastname: Kejriwal
authors.forename: Hitesh
authors.initials: H
authors.lastname: Patel
authors.forename: Jonathan
authors.initials: J
authors.lastname: Christiansen
authors.forename: Anthony
authors.initials: A
authors.lastname: Scott
authors.forename: Hamish
authors.initials: H
authors.lastname: Hart
authors.forename: Colin
authors.initials: C
authors.lastname: Edwards
authors.forename: Guy
authors.initials: G
authors.lastname: Armstrong
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000706:statistics & numerical data*; D005260:Female; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D009520:New Zealand; D013997:Time Factors; D014850:Waiting Lists