UTILIZATION OF EMERGENCY MEDICAL-SERVICES FOR SYMPTOMS OF ACUTE MYOCARDIAL-INFARCTION

Objective: To examine patient characteristics and situational and clin ical factors that affect utilization of Emergency Medical Services (EM S) for symptoms of acute myocardial infarction (AMI). Design: Telephon e interview of patients hospitalized with suspected AMI. Setting: Nine hospitals in King County, Washington. Patients: Patients admitted to a coronary or intensive care unit between October 1, 1986, and Decembe r 31, 1987, with suspected AMI occurring out of hospital. Spouses of p atients who met criteria but died during the hospitalization also part icipated. Outcome Measures: Patient demographics, coping strategies, s ituational factors, prior cardiac history, perceived symptom severity, belief about the nature of condition, and method of transportation. R esults: Descriptive statistics showed that although few patients calle d EMS as a ''first thing'' in response to symptoms, almost half of all patients called EMS before being hospitalized. Stepwise logistic regr ession analyses revealed that being older, the belief that one was exp eriencing a heart attack, the presence of other people (including the spouse), and the lack of physical activity at time of symptom onset, w ere related to both greater and quicker utilization of EMS. Additional ly, education, medical history of angina, and severity of symptoms als o were related to utilization of EMS. Conclusion: The findings are dis cussed in a theoretical context, using Leventhal's self-regulatory mod el to suggest avenues for future research and interventions.