TRENDS IN THE HOME MANAGEMENT OF NONFATAL ACUTE MYOCARDIAL-INFARCTIONIN PERTH, WESTERN-AUSTRALIA BETWEEN 1984 AND 1993

Background: Trends in the incidence of acute myocardial infarction (AM I) that are based on admissions to hospital would be misleading if the proportion of non-fatal infarctions treated at home changed over time . Aim: To estimate trends in the management at home of cases of non-fa tal AMI in Perth between 1984 and 1993 in order to determine if the nu mber of such cases has remained consistently small and can be neglecte d in studies of the incidence of AMI. Methods: In 1989, 251 general pr actitioners in Perth responded to a postal questionnaire asking about management of cases of AMI at home in the preceding 12 months. In 1993 , 288 general practitioners and 174 physicians responded to the same q uestionnaire. Results: We estimate that 1.5% of all patients less than 65 years of age diagnosed with non-fatal AMI were managed at home in 1989. The corresponding figure for 1993 was 4.1%. A previous study in Perth in 1984 found that 3.9% of cases of non-fatal AMI in patients le ss than 65 years of age were managed at home. C Conclusion: The manage ment at home of cases of non-fatal AMI in people of working age in Per th has remained at a negligible level from 1984 to 1993. Thus a regist er based on admissions to hospital for AMI will accurately reflect tre nds in AMI in people of working age.