# Association Between Inequality of Emergency Medical Supply Resources and In-Hospital Mortality in Patients With Acute Myocardial Infarction

## TL;DR

This study shows that unequal distribution of emergency medical resources in South Korea is linked to higher in-hospital deaths from heart attacks.

## Contribution

The study provides new evidence linking regional inequality in emergency medical resources to AMI mortality.

## Key findings

- Higher inequality in emergency PCI availability was associated with increased in-hospital mortality.
- Patients in regions with the highest inequality had a 68.9% higher mortality risk compared to the lowest inequality regions.

## Abstract

This study aimed to investigate the relationship between regional inequality in emergency medical supply resources and in-hospital mortality among patients with acute myocardial infarction (AMI) in South Korea.

We analyzed data from the Korean National Health Insurance Service claims database, focusing on 53,770 AMI patients admitted to emergency departments between 2012 and 2020. The inequality index of emergency medical supply resources was calculated based on the availability of emergency percutaneous coronary interventions (PCI) within each region.

Among 53,770 AMI patients, 4,840 (9.0%) died in-hospital. After adjusting for covariates, patients residing in areas with higher inequality indices had increased risk of in-hospital mortality compared to those in areas with the lowest inequality (index 0.50–0.75: HR 1.504, 95% CI 1.198–1.889; index ≥0.75: HR 1.689, 95% CI 1.493–1.910).

This study highlights the importance of equitable distribution of emergency medical resources to reduce in-hospital mortality among AMI patients. Policymakers should prioritize strategies to address regional disparities in emergency medical supply resources to improve health outcomes.