Objectives-To investigate socioeconomic variations in the utilisation of tertiary cardiology services.
Design-Cross sectional ecological study, using the Super Profile classification of enumeration districts, and ischaemic heart disease standardised mortality ratios as a proxy for need.
Setting-The former Yorkshire Regional Health Authority area in England and its seven constituent district health authority areas.
Subjects-Patients with a primary diagnosis of ischaemic heart disease aged = 25 years who underwent investigation by angiography, or treatment by coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA), as a primary procedure between April 1992 and March 1994 in an NHS hospital.
Main results-There is an overall increasing trend in investigation and revascularisation rates from the affluent to the deprived in the region suggesting equity.
However, the gradient is slight compared with the corresponding mortality gradient.
Age specific analysis shows a more appropriate trend in rates for the under 65s, but a downward trend from affluence to deprivation for the elderly.
Much of the regional trend is caused by very high rates in one geographically small but densely populated district that has two tertiary cardiology centres.
In other districts, with higher heart disease mortality but much lower procedure rates, there is a decreasing trend from the affluent to the deprived suggesting considerable inequity. (...)
Mots-clés Pascal : Infarctus, Myocarde, Cardiopathie coronaire, Revascularisation chirurgicale, Traitement, Statut socioéconomique, Variation géographique, Etats Unis, Amérique du Nord, Amérique, Accessibilité, Soin intensif, Homme, Service santé, Système santé, Appareil circulatoire pathologie, Myocarde pathologie, Chirurgie
Mots-clés Pascal anglais : Infarct, Myocardium, Coronary heart disease, Surgical revascularization, Treatment, Socioeconomic status, Geographical variation, United States, North America, America, Accessibility, Intensive care, Human, Health service, Health system, Cardiovascular disease, Myocardial disease, Surgery
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0425690
Code Inist : 002B30A01B. Création : 25/01/1999.