| Titre : | Does increased investment in coronary angiography and revascularisation reduce socioeconomic inequalities in utilisation ? (1999) |
| Auteurs : | C.J. MANSON-SIDDLE ; M.B. ROBINSON |
| Type de document : | Article |
| Dans : | Journal of epidemiology and community health (vol. 53, n° 9, 1999) |
| Pagination : | 572-577 |
| Langues: | Anglais |
| Mots-clés : | Cardiopathie coronaire ; Homme ; Facteur socioéconomique ; Accès soins ; Inégalité devant soins ; Soins ; Angiographie ; Promotion santé ; Royaume Uni ; Europe ; Epidémiologie ; Structure hospitalière ; Appareil circulatoire [pathologie] ; Radiodiagnostic |
| Résumé : | [BDSP. Notice produite par INIST 46IfLR0x. Diffusion soumise à autorisation]. Objectives-To investigate whether additional resources for tertiary cardiology services, aimed at increasing coronary angiography and revascularisation rates, can improve socioeconomic equity of utilisation. Design-Cross sectional ecological study, using the Super Profile classification of enumeration districts and ischaemic heart disease (IHD) standardised mortality ratios (SMR) as a proxy for need. The degree of equity before the provision of extra resources was determined using data for April 1992 to March 1994, and the corresponding picture after, using data for April 1994 to March 1996. Setting-South Humberside (United Health - Grimsby and Scunthorpe Health Authority, a district of the former Yorkshire Region, before the April 1996 boundary changes). Subjects-Patients with a primary diagnosis of IHD aged >= 25 years who underwent investigation by angiography, or treatment by coronary artery bypass grafting or percutaneous transluminal coronary angioplasty, as a primary procedure. Main results-In 1992/4, before concerted intervention, both investigation and revascularisation rates, although increasing, were low in Grimsby and Scunthorpe district compared with most other districts in the Yorkshire Region. Also, there was a decreasing trend across Super Profile Lifestyle groups from the Affluent Achievers to the Have-Nots despite a twofold increase in SMRs indicating the greater need of the more deprived. (...) |
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