Assessing equity in access to health care provision in the UK : does where you live affect your chances of getting a coronary artery bypass graft ?
Study objectives-Equity should be monitored routinely for all health care services, but ideal studies for each service would be prohibitively expensive and time consuming.
A simple, quick, and cheap method for the preliminary exploration of equity in health care provision using routine data was devised.
This method was illustrated by examining whether coronary artery bypass graft (CABG) operations reflect socioeconomic differences in ischaemic heart disease (IHD) mortality.
Design-Ecological comparison of operation rates was undertaken for CABG for 1991 and IHD mortality for 1981-85 by quartiles of Townsend deprivation score.
Setting-North East Thames Regional Health Authority, London, UK.
Subjects-All residents of this region aged 35-74 were the denominator population.
Numerators were 26 834 IHD deaths and 1041 CABG operations for the defined time periods.
Main results-IHD mortality showed a steady, significant increase with increasing area deprivation scores for both men and women.
CABG rate ratios increased linearly for women, while for men there was a U shaped pattern, being lowest for the second and third quartiles.
Conclusions-Inequities may exist in the provision of CABG operations for men in this region and this finding should be the stimulus for further detailed studies.
Other health care systems should also examine equity in provision.
Mots-clés Pascal : Circulation extracorporelle, Artère coronaire, Cardiopathie coronaire, Accessibilité, Soin, Sexe, Statut socioéconomique, Variation géographique, Royaume Uni, Europe, Système santé, Homme, Chirurgie, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Cardiopulmonary bypass, Coronary artery, Coronary heart disease, Accessibility, Care, Sex, Socioeconomic status, Geographical variation, United Kingdom, Europe, Health system, Human, Surgery, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0330046
Code Inist : 002B25E. Création : 01/03/1996.