Socioeconomic inequities in invasive cardiac procedures after first myocardial infarction in Finland in 1995.
OBJECTIVE
We examined socioeconomic disparities in coronary procedure rates after first events among hospitalized myocardial infarction (MI) patients.


METHODS
Information on MI patients in 1995 in Finland was obtained from the Finnish Cardiovascular Disease Register Project. Data on comorbidity, invasive treatments, hospitalizations, mortality, and socioeconomic status were obtained by linking data from the Finnish Hospital Discharge Register, cause of death register, population census, and the health insurance register using personal identity numbers.


RESULTS
In 1995, 5172 patients aged 40 to 74 years were hospitalized for first MI. This corresponds to age-standardized event rates of 354/100,000 for men and 152/100,000 for women. Within 2 years, 33% of men and 21% of women underwent an invasive coronary procedure. Men in the lowest income third underwent 25% (95% confidence interval [CI] 12-36) fewer procedures than men in the highest third. Among women, the corresponding difference was 43% (95% CI 24-57). These disparities persisted throughout the 2-year follow-up, and they were not reduced by adjustment for comorbidity or hospital district.


CONCLUSIONS
Socioeconomic disparities were observed in receipt of invasive cardiac procedures. More attention should be paid to equitable distribution of scarce health care resources.
Hetemaa
Tiina
T
National Research and Development Centre for Welfare and Health (STAKES), Outcome and Equity Research, Lintulahdenkuja 4, 00530, Helsinki, Finland. tiina.hetemaa@stakes.fi
Keskimäki
Ilmo
I
Salomaa
Veikko
V
Mähönen
Markku
M
Manderbacka
Kristiina
K
Koskinen
Seppo
S
D000328:Adult; D000368:Aged; D019352:Censuses; D005260:Female; D005387:Finland / Q000453:epidemiology; D015276:Health Care Rationing / Q000379:methods / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D008297:Male; D008498:Medical Record Linkage; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000601:surgery*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D012935:Social Justice; D012959:Socioeconomic Factors