BACKGROUND: Prolonged delay in seeking care for @entity583 ( @entity583 ) is associated with decreased use of time-dependent treatments and increased mortality and morbidity. METHODS: Time from symptom onset to arrival at hospital and emergency medical service use were abstracted from medical records of 18,928 @entity1 hospitalized for @entity583 and captured in the community surveillance component of the ARIC study from 1987 to 2000. A cut point of 4 hours was used to assess clinically relevant delay time recommendations for treatment with current therapies. RESULTS: In 2000, the overall proportion of @entity1 with delays from symptom onset to hospital arrival of > or = 4 hours was 49.5%. Blacks and @entity1 consistently delayed longer than whites and @entity1 . Between 1987 and 2000, there was no statistically significant change in the proportion of @entity1 delaying > or = 4 hours (relative change +0.6% in @entity1 , -7.4% in @entity1 , -2.3% in whites, -8.9% in blacks, -7.9% in @entity1 with @entity6 , and -0.8% in @entity1 without @entity6 ); however, there is a noticeable narrowing of gaps between sex, race, and @entity6 status over the study period. The percentage of those who used emergency medical services increased significantly over the study period (1987 37.1%, 2000 44.5%, P < or = .0001). CONCLUSIONS: Many @entity1 continue to experience prolonged delays from onset of symptoms to hospital arrival. Delay time for hospitalized @entity583 changed little in the ARIC communities from 1987 to 2000. New public health strategies should be developed to facilitate rapid access to acute care for @entity583 .

Trends in prehospital delay time and use of emergency medical services for XXXX : experience in 4 US communities from 1987-2000.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'persons', 'men'] @entity583 :: ('MESH:D009203', 'Disease') :: ['AMI', 'acute myocardial infarction'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes']
@entity583 :: (MESH:D009203,Disease) :: ['acute myocardial infarction']
