英国社区护理:减少心力衰竭中的社会经济不平等
Nathaniel M Hawkins1, Shaun Scholes, Madhavi Bajekal
1Institute of Cardiovascular Medicine and Sciences, Liverpool Heart and Chest Hospital, Thomas Dr., Liverpool, UK. nathawkins@hotmail.com
Circulation
|July 28, 2012
概括
心力衰竭 (HF) 的发生率和患病率正在下降. 对于HF的医疗治疗在社会经济群体之间是公平的,没有观察到结果的显著差异. 进一步的努力应集中在根本原因上,并增加整体治疗.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 医疗服务研究 医疗服务研究
背景情况:
- 社会经济贫困与心力衰竭 (HF) 率,住院病例和死亡率的增加有关.
- 关于在社会经济层面上平等获得拯救生命的高频率医学疗法存在不确定性.
- 这项研究调查了基于社会经济地位的HF患者接受医疗治疗的趋势.
研究的目的:
- 检查对心力衰竭 (HF) 关键医学疗法的吸收的长期趋势.
- 评估是否在不同的社会经济环境下提供增强生存的医疗治疗是公平的.
- 分析与社会经济因素相关的HF发病率,流行率和存活率的趋势.
主要方法:
- 从英格兰 (1999年和2007年) 的全国代表性初级保健数据的横截面观察分析.
- 利用通用实践研究数据库,包括13,330名患有HF的患者.
- 社会经济地位是使用2007年多重贫困指数来确定的;治疗的开始是根据年龄标准化的.
主要成果:
- 随着时间的推移,HF发病率和患病率下降,社会经济梯度缩小.
- 关键HF治疗的摄入量显著改善:ACE抑制剂/ARB (46%至64%),β-阻断剂 (12%至41%) 和螺旋 (3%至20%).
- 在治疗开始或病例死亡方面没有观察到一致的社会经济梯度,这表明公平的护理.
结论:
- 在HF发病率和患病率的社会经济梯度正在减少.
- 心力衰竭的治疗在很大程度上是公平的,无论社会经济状况如何.
- 没有发现患者结果的重大不平等,这表明有效和公平的护理提供.
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