在安大略省获得心脏诊断服务的差异和不平等加拿大加拿大
Gavin Wardle1, Anthony J Sanfilippo2, Ashrut Narula1
1Preyra Solutions Group, 172 Palmerston Ave. Toronto ON M6J 2J4 Canada.
Health policy (Amsterdam, Netherlands)
|April 2, 2024
概括
即使考虑到患者的年龄,性别和心脏病发病率,心声回声扫描使用的区域差异仍然存在. 仍然存在显著的差异,突出了与健康的社会决定因素相关的潜在不平等.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
背景情况:
- 在不同地区,心声回声学的利用率有很大差异.
- 了解这些变化的驱动因素对于公平的医疗保健服务至关重要.
研究的目的:
- 量化安大略省回声心脏学使用的区域差异.
- 确定这些变化在多大程度上是由人口年龄,性别,心脏病流行率 (CDP) 和健康的社会决定因素 (SDH) 风险解释的.
主要方法:
- 在安大略省对695,622次心声回声检查 (2019/20) 的观察性研究.
- 测量了原始和标准化的区域心声回声率.
- 根据年龄,性别,CDP和SDH风险的标准化率.
主要成果:
- 即使对年龄,性别和CDP进行了标准化,最高率的地区的心声回声率比最低的地区高出57%.
- 48%的总变化仍然无法通过年龄,性别和CDP来解释.
- 心脏病患病率随着SDH风险的增加而增加,获得大多数心脏诊断与SDH风险有负相关性.
结论:
- 仅根据年龄和性别进行调整可能会高估心声回声学使用的不合理变化.
- 尽管存在供应商认证政策,但仍存在显著的区域差异.
- 变化与SDH风险之间的关联表明需要解决在获取和结果方面的不平等问题.
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