Is hospital care involved in inequalities in coronary heart disease mortality ? Results from the French WHO-MONICA Project in men aged 30-64.
Objectives The goal of the study was to assess whether possible disparities in coronary heart disease (CHD) management between occupational categories (OC) in men might be observed and contribute to the increasing inequalities in CHD morbidity and mortality reported in France.
Methods The data from the three registers of the French MONICA Collaborative Centres (MCC-Lille, MCC-Strasbourg, and MCC-Toulouse) were analysed during two periods : 1985-87 and 1989-91.
Acute myocardial infarctions and coronary deaths concerning men, aged 30-64 years, were included.
Non-professionally active and retired men were excluded.
Results were adjusted for age and MCC, using a logistic regression analysis.
Results 605 and 695 events were analysed for 1985-87 and 1989-91, respectively.
Out of hospital cardiac arrests, with or without cardiac resuscitation, and 28 day case fatality rates were lower among upper executives in both periods.
A coronarography before the acute event had been performed more frequently in men of this category and the proportion of events that could be hospitalised was higher among them.
In both periods, the management of acute myocardial infarctions in hospital and prescriptions on discharge were similar among occupational categories.
Conclusions For patients who could be admitted to hospital, the management was found to be similar among OCs, as was the 28 day case fatality rate among the hospitalised patients. (...)
Mots-clés Pascal : Cardiopathie coronaire, Période préhospitalière, Mortalité, Morbidité, Activité professionnelle, Catégorie socioprofessionnelle, Traitement, Efficacité traitement, Homme, France, Europe, Etude comparative, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Coronary heart disease, Prehospital period, Mortality, Morbidity, Professional activity, Socioeconomic category, Treatment, Treatment efficiency, Human, France, Europe, Comparative study, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0477518
Code Inist : 002B12A03. Création : 19/02/1999.