NDLI: Access to coronary catheterisation: fair shares for all?

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Access to coronary catheterisation: fair shares for all?

Content Provider	Semantic Scholar
Author	Kee, Frank Gaffney, Brian Currie, Shawn R. O'reilly, D.
Copyright Year	1993
Abstract	OBJECTIVE To determine the effects of patient's sex and area's material deprivation on utilisation rates of coronary catheterisation and angiography in the investigation of ischaemic heart disease. DESIGN Retrospective analysis of routinely collected hospital statistics. SETTING Acute hospitals throughout Northern Ireland. SUBJECTS 24,179 episodes of patients discharged from hospital with a primary diagnosis of ischaemic heart disease and 1270 episodes relating to patients with an underlying diagnosis of ischaemic heart disease who had either coronary catheterisation or angiography. MAIN OUTCOME MEASURES Age standardised admission rates for heart disease and age standardised utilisation rates for catheterisation or angiography, or both, for 566 electoral wards ranked by Townsend "deprivation" scores. RESULTS Catheterisation-angiography rates in men were over fivefold those of women, ranging from 85.5/100,000 v 16/100,000 in patients from "well off" areas to 123/100,000 v 22/100,000 for patients from deprived areas. After admission rates for heart disease were controlled for, the overall rate ratio for women was 0.48 (95% confidence interval 0.38 to 0.60). After differential admission rates for heart disease and other potential clinical confounders were controlled for, the investigation rates of patients from the least and most "deprived" areas were not significantly different (rate ratio 1.04 (0.87 to 1.25)). CONCLUSION Although investigation rates were significantly lower in women than in men, further clinical data would be required before labelling this underutilisation as evidence of bias. There was no significant difference in invasive investigation rates for heart disease in areas of varying deprivation or affluence.
Starting Page	299
Ending Page	306
Page Count	8
File Format	PDF HTM / HTML
Alternate Webpage(s)	http://www.bmj.com/content/bmj/307/6915/1305.full.pdf
PubMed reference number	8257883v1
Volume Number	307
Issue Number	6915
Journal	BMJ
Language	English
Access Restriction	Open
Subject Keyword	Catheterization Confidence Intervals Coronary Artery Vasospasm Heart Diseases Myocardial Ischemia Paget's Disease, Mammary Patients Ward (environment) angiogram
Content Type	Text
Resource Type	Article

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