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November 1, 2000

Barriers to Patients Seeking Emergency Care for Acute Coronary Heart Disease

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(17):2184. doi:10.1001/jama.284.17.2184

To the Editor: It should come as no surprise that the community educational intervention described by Dr Luepker and colleagues1 had no impact on the average time interval from onset of symptoms suggestive of myocardial infarction to arrival at the emergency department. There have been other studies with similar interventions and similar results.2,3 One set of studies, conducted in Sweden, did show a statistically significant improvement in delay time.4 This difference from the US experience may have been due to the difference in health care–related financial barriers between the United States and Sweden. Even the Swedish study, however, showed no improvement in mortality rates.

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