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dc.contributor.authorTimonin, Sergey
dc.contributor.authorKontsevaya, Anna
dc.contributor.authorMcKee, Martin
dc.contributor.authorLeon, David Adrew
dc.date.accessioned2022-04-27T10:37:13Z
dc.date.available2022-04-27T10:37:13Z
dc.date.issued2018-08-01
dc.description.abstractBackground: Russia has the largest area of any country in the world and has one of the highest cardiovascular mortality rates. Over the past decade, the number of facilities able to perform percutaneous coronary interventions (PCIs) has increased substantially. We quantify the extent to which the constraints of geography make equitable access to this effective technology difficult to achieve.<p> <p>Methods: Hospitals performing PCIs in 2010 and 2015 were identified and combined with data on the population of districts throughout the country. A network analysis tool was used to calculate road-travel times to the nearest PCI facility for those aged 40þ years.<p> <p>Results: The number of PCI facilities increased from 144 to 260 between 2010 and 2015. Overall, the median travel time to the closest PCI facility was 48 minutes in 2015, down from 73 minutes in 2010. Two-thirds of the urban population were within 60 minutes’ travel time to a PCI facility in 2015, but only one-fifth of the rural population. Creating 67 new PCI facilities in currently underserved urban districts would increase the population share within 60 minutes’ travel to 62% of the population, benefiting an additional 5.7 million people currently lacking adequate access.<p> <p>Conclusions: There have been considerable but uneven improvements in timely access to PCI facilities in Russia between 2010 and 2015. Russia has not achieved the level of access seen in other large countries with dispersed populations, such as Australian and Canada. However, creating a relatively small number of further PCI facilities could improve access substantially, thereby reducing inequality.en_US
dc.identifier.citationTimonin S, Kontsevaya, McKee M, Leon DA. Reducing geographic inequalities in access times for acute treatment of myocardial infarction in a large country: the example of Russia. International Journal of Epidemiology. 2018;47(5):1594-1602en_US
dc.identifier.cristinIDFRIDAID 1639436
dc.identifier.doi10.1093/ije/dyy146
dc.identifier.issn0300-5771
dc.identifier.issn1464-3685
dc.identifier.urihttps://hdl.handle.net/10037/24907
dc.language.isoengen_US
dc.publisherOxford University Pressen_US
dc.relation.journalInternational Journal of Epidemiology
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2018 The Author(s)en_US
dc.titleReducing geographic inequalities in access times for acute treatment of myocardial infarction in a large country: the example of Russiaen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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