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Inequality in Access to Coronary Angiograms in UK |
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Written by Dr Margaret
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Apr 30, 2008 at 05:47 AM |
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Inequality in access to Coronary Angiograms A study in the British Medical Journal demonstrated that for patients with Stable effort related chest pain(effort angina) men are more likely to receive an angiogram to investigate their symptoms than women, angiography was less likely to be performed in patients aged over 64 compared with those aged under 50 , women compared with men , south Asians compared with white people , and patients in the most deprived fifth compared with the other four fifths. Not undergoing angiography when it was deemed appropriate was associated with higher rates of coronary event. At an early stage after presentation with chest pain suggestive of angina, coronary angiography is underused in older people, women, south Asians, and people from deprived areas. Despite the strong emphasis on fairness of access to cardiac investigation in the UK national service framework for coronary heart disease published in 2000, we found that older people, women, and south Asians who were deemed appropriate for coronary angiography were significantly less likely to receive the investigation. Deaths from coronary heart disease and admissions for unstable angina and myocardial infarction were more common in patients deemed appropriate for coronary angiography but who had not received it. Not receiving appropriate angiography was associated with a higher risk of coronary events in all groups. Interventions based on clinical guidance that supports individualised management decisions might improve access and outcomesHeha Sehkri and colleagues Inequity of access to investigation and effect on clinical outcomes: prognostic study of coronary angiography for suspected stable angina pectoris British Medical Journal April 24,2008
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Last Updated ( May 04, 2008 at 05:21 AM )
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