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首页> 外文期刊>Heart, lung & circulation >Socioeconomic Equity in the Receipt of In-Hospital Care and Outcomes in Australian Acute Coronary Syndrome Patients: The CONCORDANCE Registry
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Socioeconomic Equity in the Receipt of In-Hospital Care and Outcomes in Australian Acute Coronary Syndrome Patients: The CONCORDANCE Registry

机译：在澳大利亚急性冠状动脉综合征患者中接受住院护理和结果的社会经济股权：一致注册管理机构

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BackgroundSocioeconomic status (SES) is a social determinant of both health and receipt of health care services, but its impact is under-studied in acute coronary syndrome (ACS). The aim of this study was to examine the influence of SES on in-hospital care, and clinical events for patients presenting with an ACS to public hospitals in Australia. MethodsData from 9064 ACS patient records were collected from 41 public hospitals nationwide from 2009 as part of the Cooperative National Registry of Acute Coronary Syndrome Care (CONCORDANCE) registry. For this analysis, we divided the cohort into four socioeconomic groups (based on postcode of usual residence) and compared the in-hospital care provided and clinical outcomes before and after adjustment for both patient clinical characteristics and hospital clustering. ResultsPatients were divided into four SES groups (from the most to the least disadvantaged: 2042 (23%) vs. 2104 (23%) vs. 1994 (22%) vs. 2968 (32%)). Following adjustments for patient characteristics, there were no differences in the odds of receiving coronary angiogram, revascularisation, prescription of recommended medication, or referral to cardiac rehabilitation across the SES groups (p=0.06, 0.69, 0.89 and 0.79, respectively). After adjustment for clinical characteristics, no associations were observed for in-hospital and cumulative death (p=0.62 and p=0.71, respectively).However, the most disadvantaged group were 37% more likely to have a major adverse cardiovascular event (MACE) than the least disadvantaged group (OR (95% CI): 1.37 (1.1, 1.71), p=0.02) driven by incidence of in-hospital heart failure. ConclusionsAlthough there may be gaps in the delivery of care, this delivery of care does not differ by patient's SES. It is an encouraging affirmation that all patients in Australian public hospitals receive equal in-hospital care, and the likelihood of death is comparable between the SES groups.
机译：背景性社会状况（SES）是健康和收到医疗服务的社会决定因素，但其影响是在急性冠状动脉综合征（ACS）中进行的。本研究的目的是探讨SES对住院内护理的影响，以及患者与ACS在澳大利亚公立医院提供的患者的临床活动。方法从2009年从2009年的41个公立医院收集了来自9064个ACS患者记录的方法，作为急性冠状动脉综合征护理（一致）注册管理机构的合作国家注册机构的一部分。对于这种分析，我们将群组分为四个社会经济群体（基于通常的常规居住的邮政编码），并比较了患者临床特征和医院聚类的治疗前后的住院护理和临床结果。结果含量分为四个SES基团（从最缺乏缺点：2042（23％）与2104（23％）与1994（22％）与2968（32％））分为2104（23％））。在对患者特征进行调整后，接受冠状动脉血管造影，血管体外，推荐药物的血型血管造影，血型血管疗法，或转诊到SES组的心脏康复的可能性没有差异（P = 0.06,0.69,0.89和0.79）。调整临床特征后，没有观察到医院内和累积死亡的关联（P = 0.62和P = 0.71）。无论，最弱势群体都有37％，可能有一个主要的不良心血管事件（MACE）比最不弱势群体（或（95％CI）：1.37（1.1,1.71），P = 0.02），受到医院内心力衰竭的发生。结论虽然在护理的交付中可能存在差距，但这种护理的递送并没有患者的SES不同。这是一项令人鼓舞的肯定，澳大利亚公立医院的所有患者都接受了平等的住院医院，死亡的可能性在SES团体之间是可比的。

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