The Association between Hospital Volume and Survival after Acute Myocardial Infarction in Elderly Patients

In most of the United States, patients with chest pain thought to be due to acute coronary ischemia are taken by ambulance to the nearest hospital rather than to tertiary centers that treat a large number (high volume) of patients with acute myocardial infarction. The destination is determined by proximity alone, both for efficient operation of the emergency medical transportation system and because time is deemed paramount. The importance of experience on the part of the hospital and physician as a determinant of the patient's survival has been increasingly recognized for various specialties and procedures. 1 – 9 To determine whether hospital . . .