This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hetemaa, T. Articles by Keskimäki, I. Search for Related Content PubMed PubMed Citation Articles by Hetemaa, T. Articles by Keskimäki, I. Pubmed/NCBI databases Medline Plus Health Information Angina Heart Attack Heart Surgery Social Bookmarking                         What's this?

Socioeconomic inequities in invasive cardiac procedures among patients with incident angina pectoris or myocardial infarction

National Research and Development Centre for Welfare and Health (STAKES), Outcomes and Equity Research, Helsinki Finland, tiina.hetemaa{at}stakes.fi

Kristiina Manderbacka

National Research and Development Centre for Welfare and Health (STAKES), Outcomes and Equity Research, Helsinki Finland

Antti Reunanen

National Public Health Institute, Department of Health and Functional Capacity, Helsinki Finland

Seppo Koskinen

National Public Health Institute, Department of Health and Functional Capacity, Helsinki Finland

Ilmo Keskimäki

National Research and Development Centre for Welfare and Health (STAKES), Outcomes and Equity Research, Helsinki Finland

Aims: In many countries, systematic socioeconomic disparities have emerged in the use of invasive cardiac procedures among myocardial infarction patients and hospitalized coronary patients. This study prospectively examined socioeconomic differences in the use of cardiac procedures in a national cohort of incident coronary patients. Methods: The data were based on individual register linkages among 49,846 patients with incident angina pectoris (AP) or myocardial infarction (MI) during one-year follow-up in 1995—98 in Finland. Socioeconomic differences in invasive coronary procedures were examined using proportional hazard models. Results: The analyses showed that women, AP patients, and persons with lower socioeconomic status received fewer procedures during the one-year follow-up than men, MI patients, and those with higher socioeconomic status. Socioeconomic differences in the utilization of cardiac procedures were similar in both AP and MI groups, among both men and women, and by all socioeconomic indicators: social class, education, and income. Disparities were already emerging after the 28-day follow-up among men and women in both patient groups, and they persisted throughout the study period. Controlling for disease severity, comorbidity, and hospital district did not modify the results. Conclusions: Socioeconomic disparities in receiving invasive coronary procedures among AP patients without MI were similar to those in MI patients.

Key Words: Cardiac procedures • coronary heart disease • social inequity

Scandinavian Journal of Public Health, Vol. 34, No. 2, 116-123 (2006)
DOI: 10.1080/14034940510032248


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?