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The distribution of cardiac diagnostic testing for acute coronary syndrome in the Brazilian healthcare system: A national geospatial evaluation of health access

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Listed:
  • Julian T Hertz
  • Tommy Fu
  • Joao Ricardo Vissoci
  • Thiago Augusto Hernandes Rocha
  • Elias Carvalho
  • Brendan Flanagan
  • Luciano de Andrade
  • Alex T Limkakeng
  • Catherine A Staton

Abstract

Background: Little is known about the utilization of cardiac diagnostic testing in Brazil and how such testing is related with local rates of acute coronary syndrome (ACS)-related mortality. Methods and results: Using data from DATASUS, the public national healthcare database, absolute counts of diagnostic tests performed were calculated for each of the 5570 municipalities and mapped. Spatial error regression and geographic weighted regression models were used to describe the geographic variation in the association between ACS mortality, income, and access to diagnostic testing. Conclusions: The majority of testing for ACS in Brazil is conducted at referral centers in developed urban settings. Stress ECG is the dominant testing modality in use. Increased access to diagnostic testing was not consistently associated with decreased ACS mortality across the country.

Suggested Citation

  • Julian T Hertz & Tommy Fu & Joao Ricardo Vissoci & Thiago Augusto Hernandes Rocha & Elias Carvalho & Brendan Flanagan & Luciano de Andrade & Alex T Limkakeng & Catherine A Staton, 2019. "The distribution of cardiac diagnostic testing for acute coronary syndrome in the Brazilian healthcare system: A national geospatial evaluation of health access," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-16, January.
    • Handle: RePEc:plo:pone00:0210502
    DOI: 10.1371/journal.pone.0210502
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