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Access to coronary catheterisation: fair shares for all?
1Department of Epidemiology and Public Health, Queen's University, Belfast.
BMJ (Clinical Research Ed.)
|November 20, 1993
Summary
Investigating ischaemic heart disease with coronary catheterisation and angiography showed significantly lower rates in women compared to men. However, area deprivation did not significantly impact invasive investigation rates for heart disease.
Area of Science:
- Cardiology
- Public Health
- Health Services Research
Background:
- Ischaemic heart disease (IHD) necessitates timely investigation.
- Coronary catheterisation and angiography are key diagnostic procedures for IHD.
- Socioeconomic factors and sex may influence healthcare utilisation.
Purpose of the Study:
- To examine the impact of patient sex and area material deprivation on IHD investigation rates.
- To assess utilisation of coronary catheterisation and angiography in Northern Ireland.
Main Methods:
- Retrospective analysis of hospital statistics from acute hospitals in Northern Ireland.
- Inclusion of 24,179 IHD episodes and 1270 catheterisation/angiography episodes.
- Analysis of age-standardised admission and investigation rates by area deprivation scores (Townsend scores).
Main Results:
- Men underwent coronary catheterisation and angiography at over five times the rate of women.
- After controlling for admission rates, women's investigation rate was 0.48 (95% CI 0.38–0.60).
- No significant difference in investigation rates was found between patients from the most and least deprived areas (rate ratio 1.04; 95% CI 0.87–1.25).
Conclusions:
- While women had significantly lower investigation rates than men, further data is needed to confirm underutilisation or bias.
- Area-level material deprivation did not significantly affect invasive investigation rates for ischaemic heart disease.