{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T22:06:13Z","timestamp":1781993173696,"version":"3.54.5"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Quality and Outcomes"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>In response to urban\u2013rural disparities in healthcare resources, China recently launched a healthcare reform with a focus on improving rural care during the past decade. However, nationally representative studies comparing medical care and patient outcomes between urban and rural areas in China during this period are not available.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We created a nationally representative sample of patients in China admitted for ST-segment\u2013elevation myocardial infarction in 2001, 2006, and 2011, using a 2-stage random sampling design in 2 urban and 3 rural strata. In China, evidence-based treatments were provided less often in 2001 in rural hospitals, which had lower volume and less availability of advanced cardiac facilities. However, these differences diminished by 2011 for reperfusion therapy (54% in urban versus 57% in rural;\n              <jats:italic>P<\/jats:italic>\n              =0.1) and reversed for angiotensin-converting enzyme inhibitors\/angiotensin receptor blockers (66% versus 68%;\n              <jats:italic>P<\/jats:italic>\n              =0.04) and early \u03b2-blockers (56% versus 60%;\n              <jats:italic>P<\/jats:italic>\n              =0.01). The risk-adjusted rate of in-hospital death or withdrawal from treatment was not significantly different between urban and rural hospitals in any study year, with an adjusted odds ratio of 1.13 (0.77\u20131.65) in 2001, 0.99 (0.77\u20131.27) in 2006, and 0.94 (0.74\u20131.19) in 2011.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Although urban\u2013rural disparities in evidence-based treatment for myocardial infarction in China have largely been eliminated, substantial gaps in quality of care persist in both settings. In addition, urban hospitals providing more resource-intensive care did not achieve better outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT01624883.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circoutcomes.117.003905","type":"journal-article","created":{"date-parts":[[2017,11,21]],"date-time":"2017-11-21T01:10:40Z","timestamp":1511226640000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Urban\u2013Rural Comparisons in Hospital Admission, Treatments, and Outcomes for ST-Segment\u2013Elevation Myocardial Infarction in China From 2001 to 2011"],"prefix":"10.1161","volume":"10","author":[{"given":"Xi","family":"Li","sequence":"first","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karthik","family":"Murugiah","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Li","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederick A.","family":"Masoudi","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul S.","family":"Chan","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Hu","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Spertus","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongfei","family":"Wang","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas S.","family":"Downing","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harlan M.","family":"Krumholz","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixin","family":"Jiang","sequence":"additional","affiliation":[{"name":"From the National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing (X.L., J.L., S.H., L.J.); Yale School of Medicine (K.M., Y.W., N.S.D., H.M.K.) and Yale School of Public Health (H.M.K.), Yale University, New Haven, CT; Center for Outcomes Research and Evaluation, Yale New Haven Hospital, CT (K.M., Y.W., N.S.D...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the China PEACE Collaborative Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","volume-title":"Global Evidence on Inequities in Rural Health Protection: New Data on Rural Deficits in Health Coverage for 174 Countries","author":"Scheil-Adlung X","year":"2015","unstructured":"Scheil-Adlung XGlobal Evidence on Inequities in Rural Health Protection: New Data on Rural Deficits in Health Coverage for 174 Countries. 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