Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study.

Jeppe Nørgaard Rasmussen; Søren Rasmussen; Gunnar H Gislason; Steen Zabell Abildstrøm; Tina K Schramm; Christian Torp-Pedersen; Lars Køber; Finn Diderichsen; Merete Osler; Mette Madsen

doi:10.1007/s10557-007-6058-7

Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study.

Jeppe Nørgaard Rasmussen, Søren Rasmussen, Gunnar H Gislason, Steen Zabell Abildstrøm, Tina K Schramm, Christian Torp-Pedersen, Lars Køber, Finn Diderichsen, Merete Osler, Mette Madsen

Department of Public Health

26 Citations (Scopus)

Abstract

BACKGROUND: Use of invasive revascularization [percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)] after acute myocardial infarction (AMI) in Denmark increased between 1996 and 2004. We investigated how this affected socioeconomic differences in their use. MATERIALS AND METHODS: All patients aged 30-74 years in hospital for a first AMI in Denmark between 1996 and 2004 were included. Cox proportional hazard models were used to estimate the association between individual income (tertiles) and education (>12, 10-12 and <10 years) and time to revascularization within 6 months. Revascularization was stratified into CABG, acute PCI (within 2 days of admission) and non-acute PCI (after the third day). RESULTS: A total of 38,803 patients were included. In 1996-1998, 6.8% received CABG, 9.3% non-acute PCI and 2.4% acute PCI; in 2002-2004, these numbers were 11.8, 36.1 and 29.1%. CABG was more likely to be performed for patients with a high income [hazard ratio (HR), 1.18; 95% confidence interval (CI), 1.08-1.28] or a medium income (HR, 1.16; 95% CI, 1.07-1.25) than for those with a low income throughout the period. A similar income gradient was seen for non-acute PCI, but not for acute PCI, for which no gradient was seen. No educational gradient was found for CABG, and that for non-acute and acute PCI decreased during the period; by the end of the period, more patients with low than high education received acute PCI. CONCLUSION: In the universal health care system of Denmark, income differences in CABG and non-acute PCI persisted, whereas no such differences were seen for acute PCI.
Udgivelsesdato: 2007-Dec

Original language	English
Journal	Cardiovascular Drugs and Therapy
Volume	21
Issue number	6
Pages (from-to)	449-457
Number of pages	8
ISSN	0920-3206
DOIs	https://doi.org/10.1007/s10557-007-6058-7
Publication status	Published - 2007

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Rasmussen, J. N., Rasmussen, S., Gislason, G. H., Abildstrøm, S. Z., Schramm, T. K., Torp-Pedersen, C., Køber, L., Diderichsen, F., Osler, M., & Madsen, M. (2007). Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study. Cardiovascular Drugs and Therapy, 21(6), 449-457. https://doi.org/10.1007/s10557-007-6058-7

Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study. / Rasmussen, Jeppe Nørgaard; Rasmussen, Søren; Gislason, Gunnar H et al.

In: Cardiovascular Drugs and Therapy, Vol. 21, No. 6, 2007, p. 449-457.

Research output: Contribution to journal › Journal article › Research › peer-review

Rasmussen, JN, Rasmussen, S, Gislason, GH, Abildstrøm, SZ, Schramm, TK, Torp-Pedersen, C , Køber, L , Diderichsen, F , Osler, M & Madsen, M 2007, 'Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study.', Cardiovascular Drugs and Therapy, vol. 21, no. 6, pp. 449-457. https://doi.org/10.1007/s10557-007-6058-7

@article{c3904750ff6311dcbee902004c4f4f50,

title = "Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study.",

abstract = "BACKGROUND: Use of invasive revascularization [percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)] after acute myocardial infarction (AMI) in Denmark increased between 1996 and 2004. We investigated how this affected socioeconomic differences in their use. MATERIALS AND METHODS: All patients aged 30-74 years in hospital for a first AMI in Denmark between 1996 and 2004 were included. Cox proportional hazard models were used to estimate the association between individual income (tertiles) and education (>12, 10-12 and <10 years) and time to revascularization within 6 months. Revascularization was stratified into CABG, acute PCI (within 2 days of admission) and non-acute PCI (after the third day). RESULTS: A total of 38,803 patients were included. In 1996-1998, 6.8% received CABG, 9.3% non-acute PCI and 2.4% acute PCI; in 2002-2004, these numbers were 11.8, 36.1 and 29.1%. CABG was more likely to be performed for patients with a high income [hazard ratio (HR), 1.18; 95% confidence interval (CI), 1.08-1.28] or a medium income (HR, 1.16; 95% CI, 1.07-1.25) than for those with a low income throughout the period. A similar income gradient was seen for non-acute PCI, but not for acute PCI, for which no gradient was seen. No educational gradient was found for CABG, and that for non-acute and acute PCI decreased during the period; by the end of the period, more patients with low than high education received acute PCI. CONCLUSION: In the universal health care system of Denmark, income differences in CABG and non-acute PCI persisted, whereas no such differences were seen for acute PCI. Udgivelsesdato: 2007-Dec",

author = "Rasmussen, {Jeppe N{\o}rgaard} and S{\o}ren Rasmussen and Gislason, {Gunnar H} and Abildstr{\o}m, {Steen Zabell} and Schramm, {Tina K} and Christian Torp-Pedersen and Lars K{\o}ber and Finn Diderichsen and Merete Osler and Mette Madsen",

note = "Keywords: Adult; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Coronary Artery Bypass; Delivery of Health Care; Denmark; Female; Humans; Male; Middle Aged; Myocardial Infarction; Socioeconomic Factors",

year = "2007",

doi = "10.1007/s10557-007-6058-7",

language = "English",

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pages = "449--457",

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T1 - Persistent socio-economic differences in revascularization after acute myocardial infarction despite a universal health care system-a Danish study.

AU - Rasmussen, Jeppe Nørgaard

AU - Rasmussen, Søren

AU - Gislason, Gunnar H

AU - Abildstrøm, Steen Zabell

AU - Schramm, Tina K

AU - Torp-Pedersen, Christian

AU - Køber, Lars

AU - Diderichsen, Finn

AU - Osler, Merete

AU - Madsen, Mette

N1 - Keywords: Adult; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Coronary Artery Bypass; Delivery of Health Care; Denmark; Female; Humans; Male; Middle Aged; Myocardial Infarction; Socioeconomic Factors

PY - 2007

Y1 - 2007

N2 - BACKGROUND: Use of invasive revascularization [percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)] after acute myocardial infarction (AMI) in Denmark increased between 1996 and 2004. We investigated how this affected socioeconomic differences in their use. MATERIALS AND METHODS: All patients aged 30-74 years in hospital for a first AMI in Denmark between 1996 and 2004 were included. Cox proportional hazard models were used to estimate the association between individual income (tertiles) and education (>12, 10-12 and <10 years) and time to revascularization within 6 months. Revascularization was stratified into CABG, acute PCI (within 2 days of admission) and non-acute PCI (after the third day). RESULTS: A total of 38,803 patients were included. In 1996-1998, 6.8% received CABG, 9.3% non-acute PCI and 2.4% acute PCI; in 2002-2004, these numbers were 11.8, 36.1 and 29.1%. CABG was more likely to be performed for patients with a high income [hazard ratio (HR), 1.18; 95% confidence interval (CI), 1.08-1.28] or a medium income (HR, 1.16; 95% CI, 1.07-1.25) than for those with a low income throughout the period. A similar income gradient was seen for non-acute PCI, but not for acute PCI, for which no gradient was seen. No educational gradient was found for CABG, and that for non-acute and acute PCI decreased during the period; by the end of the period, more patients with low than high education received acute PCI. CONCLUSION: In the universal health care system of Denmark, income differences in CABG and non-acute PCI persisted, whereas no such differences were seen for acute PCI. Udgivelsesdato: 2007-Dec

AB - BACKGROUND: Use of invasive revascularization [percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)] after acute myocardial infarction (AMI) in Denmark increased between 1996 and 2004. We investigated how this affected socioeconomic differences in their use. MATERIALS AND METHODS: All patients aged 30-74 years in hospital for a first AMI in Denmark between 1996 and 2004 were included. Cox proportional hazard models were used to estimate the association between individual income (tertiles) and education (>12, 10-12 and <10 years) and time to revascularization within 6 months. Revascularization was stratified into CABG, acute PCI (within 2 days of admission) and non-acute PCI (after the third day). RESULTS: A total of 38,803 patients were included. In 1996-1998, 6.8% received CABG, 9.3% non-acute PCI and 2.4% acute PCI; in 2002-2004, these numbers were 11.8, 36.1 and 29.1%. CABG was more likely to be performed for patients with a high income [hazard ratio (HR), 1.18; 95% confidence interval (CI), 1.08-1.28] or a medium income (HR, 1.16; 95% CI, 1.07-1.25) than for those with a low income throughout the period. A similar income gradient was seen for non-acute PCI, but not for acute PCI, for which no gradient was seen. No educational gradient was found for CABG, and that for non-acute and acute PCI decreased during the period; by the end of the period, more patients with low than high education received acute PCI. CONCLUSION: In the universal health care system of Denmark, income differences in CABG and non-acute PCI persisted, whereas no such differences were seen for acute PCI. Udgivelsesdato: 2007-Dec

U2 - 10.1007/s10557-007-6058-7

DO - 10.1007/s10557-007-6058-7

M3 - Journal article

C2 - 17955357

SN - 0920-3206

VL - 21

SP - 449

EP - 457

JO - Cardiovascular Drugs and Therapy

JF - Cardiovascular Drugs and Therapy

IS - 6

ER -