Document Detail

Super Profile analysis of socioeconomic variations in coronary investigation and revascularisation rates.
MedLine Citation:
PMID:  9876362     Owner:  NLM     Status:  MEDLINE    
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 needs. 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 > or = 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. CONCLUSIONS: This study confirms wide socioeconomic variations in coronary investigation and revascularisation within the former Yorkshire Region, suggesting that in some districts need is not being met and that service utilisation is inequitable. Such inequities are over and above those that result from proximity to tertiary cardiology centres.
C J Manson-Siddle; M B Robinson
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of epidemiology and community health     Volume:  52     ISSN:  0143-005X     ISO Abbreviation:  J Epidemiol Community Health     Publication Date:  1998 Aug 
Date Detail:
Created Date:  1999-01-12     Completed Date:  1999-01-12     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7909766     Medline TA:  J Epidemiol Community Health     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  507-12     Citation Subset:  IM    
Nuffield Institute for Health, University of Leeds.
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MeSH Terms
Analysis of Variance
Angioplasty, Transluminal, Percutaneous Coronary
Cardiology Service, Hospital / utilization*
Cross-Sectional Studies
Great Britain / epidemiology
Middle Aged
Myocardial Ischemia / epidemiology,  surgery*
Myocardial Revascularization* / trends,  utilization
Needs Assessment
Socioeconomic Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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