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首页> 外文期刊>BMJ: British medical journal >Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study
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Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study

机译：影响社会经济剥夺的初级保健和治疗病人的负担心力衰竭的诊断实践在苏格兰:基于人口的研究

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Objectives To examine whether there are socioeconomic gradients in the incidence, prevalence, treatment, and follow up of patients with heart failure in primary care. Design Population based study. Setting 53 general practices (307 741 patients) participating in the Scottish continuous morbidity recording project between 1April 1999 and 31 March 2000. Participants 2186 adults with heart failure. Main outcome measures Comorbid diagnoses, frequency of visits to general practitioner, and prescribed drugs. Results 2186 patients with heart failure were seen (prevalence 7.1 per 1000 population, incidence 2.0 per 1000 population). The age and sex standardised incidence of heart failure increased with greater socioeconomic deprivation, from 1.8 per 1000 population in the most affluent stratum to 2.6 per 1000 population in the most deprived stratum (odds ratio 1.44, P = 0.0003). On average, patients were seen 2.4 times yearly, but follow up rates were less frequent with increasing socioeconomic deprivation (from 2.6 yearly in the most affluent subgroup to 2.0 yearly in the most deprived subgroup, P = 0.00009). Overall, 812 (80.6%) patients were prescribed diuretics, 396 (39.3%) angiotensin converting enzyme inhibitors, 216 (21.4%) β blockers, 208 (20.7%) digoxin, and 86 (8.5%) spironolactone. The wide discrepancies in prescribing between different general practices disappeared after adjustment for patient age and sex. Prescribing patterns did not vary by deprivation categories on univariate or multivariate analyses. Conclusions Compared with affluent patients, socioeconomically deprived patients were 44% more likely to develop heart failure but 23% less likely to see their general practitioner on an ongoing basis. Prescribed treatment did not differ across socioeconomic gradients.
机译：检查是否有目标社会经济梯度的发病率,患病率、治疗和随访的患者初级保健心脏衰竭。人口为基础的研究。实践(307 741名患者)的参与苏格兰连续发病率记录项目1999年4月1日和2000年3月31日之间。参与者2186成人心脏衰竭。结果共病的诊断措施,频率访问全科医生和规定药物。被认为(患病率7.1每1000人口,发病率2.0每1000人口)。性标准化心衰的发生率增加更大的社会经济剥夺,从1.8每1000人口在最富裕的地层为2.6每1000人口最多贫困的阶层(优势比为1.44,P = 0.0003)。平均而言,病人看到每年的2.4倍,但跟进利率不太频繁增加社会经济剥夺(从2.6每年在最富裕的子群,至2.0年度最贫困的子组,P =0.00009)。规定的利尿剂,396(39.3%)血管紧张素转换酶抑制剂,216(21.4%)β拦截器,208(20.7%)地高辛,86 (8.5%)螺内酯。处方不同一般的做法患者年龄和调整后消失性。在单变量或剥夺类别多变量分析。富裕的病人,socioeconomically剥夺患者44%更容易患上心脏失败但23%不太可能看到他们的将军医生在一个正在进行的基础上。在社会经济的治疗没有差别梯度。

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