Access to cardiovascular care requires geographical accessibility, infrastructural
capacity, health care quality, financial affordability, and societal acceptability.
1
In high-income countries with universal health coverage (UHC) models, such as Canada,
geographic accessibility remains 1 of the most pressing barriers.
- Vervoort D.
Moving the needle: a guide to solving the global cardiac surgery puzzle for surgeons,
societies, students, and researchers.
Published online February. 2020; 20https://doi.org/10.25373/CTSNET.11872425
2
,3
Canada is the second-largest country by total area and fourth by land mass but 236th
in terms of population density.
4
The inherent regionalization of cardiac surgery in Canada results in cardiac surgical
centres concentrating in larger cities, whereas those living outside large cities
are scattered across vast distances. Distance to cardiac care in Canada has been associated
with worse outcomes after cardiac surgery,
World Bank
Population density (people per sq km of land area).
Population density (people per sq km of land area).
https://data.worldbank.org/indicator/EN.POP.DNST
Date accessed: February 17, 2022
5
differential access to cardiac catheterization,
6
and delayed care of acute myocardial infarction.
7
In this issue of the Canadian Journal of Cardiology, Cote et al.
8
report that increased travel time (> 1 hour vs < 1 hour) in Nova Scotia may be associated
with increased long-term mortality after ascending thoracic aortic surgery (hazard
ratio [HR], 2.19; 95% confidence interval [CI], 1.13-4.28; P = 0.02). Although Nova Scotia is Canada’s second most densely populated province,
its population density would rank 213th on the list of countries.
4
In addition, the poor rural road infrastructure connecting patients across Nova Scotia
with Halifax, where Nova Scotia’s only cardiac surgical centre is located, imposes
further barriers. The authors add to their previous work on access to cardiovascular
services in Nova Scotia, helping to elucidate disparities in access to cardiovascular
care in Canada.World Bank
Population density (people per sq km of land area).
Population density (people per sq km of land area).
https://data.worldbank.org/indicator/EN.POP.DNST
Date accessed: February 17, 2022
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Article Info
Publication History
Published online: March 07, 2022
Accepted:
March 3,
2022
Received:
February 24,
2022
Footnotes
See article by Cote et al., pages 801–807 of this issue.
See page 728 for disclosure information.
Identification
Copyright
© 2022 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
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- Increased Travel Time to the Tertiary Centre Is Associated With Decreased Long-term Survival Following Ascending Aortic OperationsCanadian Journal of CardiologyVol. 38Issue 6
