[Impediments in access to medical care: experiences of people with acute myocardial infarction].
OBJECTIVE
To analyze the course followed by men and women who suffered an acute myocardial infarction until they received medical care. Knowledge of this course may be useful for making decisions that will lead to early and efficient care in the first minutes following the onset of symptoms, thereby reducing morbidity and mortality.


METHODS
Forty-three women and 54 men who suffered a painful infarction were interviewed. Data were submitted to content analysis and statistical inference.


RESULTS
The median age of men was 55.3 years and, for women of 61.5. Low education, professional inactivity and infarction taking place at home prevailed for both genders. Men had a higher family income (p=0.005) and were less likely to be living alone (p=0.001). Only 7.0% of the women made use of an ambulance. Two-thirds of the sample went directly to a hospital, but only 33% were admitted. Thus, 67.0% of the subjects wandered from place to place for up to 5 different locations before they were hospitalized. Lack of resources, denied care and being sent home by a physician were the main reasons for not being hospitalized. The place chosen for care, number of visits before hospitalization and medical attention were not gender-associated (p=NS).


CONCLUSIONS
Men and women requiring immediate care were faced with inadequate transportation and health care establishments. The health system does not appear to be equipped to provide proper care. These findings focus on the importance and the targets of health education programs and the quality of care given to infarction patients.
Escola de Enfermagem, Universidade Federal da Bahia, Rua Professor Clementino Fraga 220, Ondina, Salvador/BA, CEP 40170-050, Brazil. femussi@uol.com.br
Fernanda Carneiro
FC
Mussi
Luiz Carlos Santana
LC
Passos
Angélica Araújo de
AA
Menezes
Bruno
B
Caramelli
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001938:Brazil; D004522:Educational Status; D004632:Emergency Medical Services; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006285:Health Planning / Q000458:organization & administration; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D010146:Pain / Q000175:diagnosis / Q000209:etiology; D010342:Patient Acceptance of Health Care; D011787:Quality of Health Care; D017678:Sex Distribution