Socioeconomic inequities in invasive cardiac procedures after first myocardial infarction in Finland in 1995
Socioeconomic inequities in invasive cardiac procedures after first myocardial infarction in Finland in 1995
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DOI：
10.1016/j.jclinepi.2003.07.010
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发表时间：
2004-03-01
影响因子：
7.2
通讯作者：
Koskinen, S
中科院分区：
文献类型：
--
作者：
Hetemaa, T;Keskimäki, L;Koskinen, S
目的：我们研究住院心肌梗死（MI）患者首次事件后冠状动脉手术率的社会经济差异。研究设计和背景：芬兰1995年心肌梗死患者的信息来自芬兰心血管疾病登记项目。关于合并症、侵入性治疗、住院、死亡率和社会经济地位的数据是通过将芬兰医院出院登记册、死亡原因登记册、人口普查和使用个人身份号码的健康保险登记册的数据联系起来获得的。结果：1995年。5172名40至74岁的患者因首次心肌梗死住院。这对应于年龄标准化事件发生率，男性为354/10万，女性为152/10万。在2年内，33%的男性和21%的女性接受了有创冠状动脉手术。收入最低的三分之一的男性接受手术的次数比收入最高的三分之一的男性少25%（95%可信区间[CI] 12-36）。在女性中，相应的差异为43% （95% CI 24-57）。这些差异在2年的随访中持续存在，并没有因合并症或医院地区的调整而减少。结论：在接受有创心脏手术时存在社会经济差异。应更加重视稀缺卫生保健资源的公平分配。(C) 2004爱思唯尔公司版权所有。
Objective: We examined socioeconomic disparities in coronary procedure rates after first events among hospitalized myocardial infarction (MI) patients.Study Design and Setting: Information on MI patients in 1995 in Finland was obtained from the Finnish Cardiovascular Disease Register Project. Data on comorbidity, invasive treatments, hospitalizations, mortality, and socioeconomic status were obtained by linking data from the Finnish Hospital Discharge Register, cause of death register, population census, and the health insurance register using personal identity numbers.Results: In 1995. 5172 patients aged 40 to 74 years were hospitalized for first MI. This corresponds to age-standardized event rates of 354/100.000 for men and 152/100,000 for women. Within 2 years, 33% of men and 21% of women underwent an invasive coronary procedure. Men in the lowest income third underwent 25% (95% confidence interval [CI] 12-36) fewer procedures than men in the highest third. Among women, the corresponding difference was 43% (95% CI 24-57). These disparities persisted throughout the 2-year followup, and they were not reduced by adjustment for comorbidity or hospital district.Conclusion: Socioeconomic disparities were observed in receipt of invasive cardiac procedures. More attention should be paid to equitable distribution of scarce health care resources.(C) 2004 Elsevier Inc. All rights reserved.