Linked Life Data

15474204

Source:http://linkedlifedata.com/resource/pubmed/id/15474204

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
12
pubmed:dateCreated
2004-10-11
pubmed:abstractText
Although the mortality and incidence of coronary heart disease (CHD) in England and Wales has declined in recent years, an ageing population has contributed to keeping the prevalence of CHD largely unchanged. Evidence suggests that revascularisation procedures have contributed not only to this decline in mortality, but also to the decline in morbidity from heart disease, and to improvements in quality of life, even in old age. Despite clinical evidence of benefit, revascularisation is less often provided for older people and for women. This paper considers the equity of the provision of revascularisation according to need by gender and age using the Hospital Episodes Statistics (HES) database which includes all NHS hospital admissions in England. Trends from 1991 to 1999 were examined comparing admissions for acute myocardial infarction (as a proxy indicator of need in the absence of direct measures) and the procedures coronary artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA). The rates of CABG and PTCA have increased dramatically by 72% and 48%, respectively, between 1991/3 and 1997/9. Making allowance for differences in need, to achieve equitable provision with men, over 12,000 extra CABG and over 5000 PTCA procedures would be required for women, amounting to 19% and 10% increases in the total volume of each procedure, respectively. Similarly, attempting to meet need up to the age of 79 years would require over 13,000 extra CABG and over 13,000 PTCA procedures for men, and an additional 14,300 CABG and almost 10,000 extra PTCA procedures for women, representing 42% and 40% increases in CABG and PTCA, respectively. As women tend to present with CHD at older ages this indicates that they may be the victims of a 'double whammy' of inequity. Moreover, these inequities have remained constant through the study period. Possible explanations for this shortfall of provision are proposed.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Dec
pubmed:issn
0277-9536
pubmed:author
pubmed:issnType
Print
pubmed:volume
59
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2499-507
pubmed:dateRevised
2010-11-18
pubmed:meshHeading
pubmed:year
2004
pubmed:articleTitle
Gender and age inequity in the provision of coronary revascularisation in England in the 1990s: is it getting better?
pubmed:affiliation
Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK. mary.shaw@bristol.ac.uk
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't