Abstract
Purpose: To quantify and compare citywide disparities in the performance of coronary revascularization procedures in New York residents diagnosed with ischemic heart disease (IHD) by the characteristics of the patients and their neighborhood of residence in 2000–2002 and 2011–2013.Methods: We identify the number of hospitalizations for patients with diagnoses of IHD and/or congestive heart failure (CHF) and the number of revascularization procedures performed on the population 45 years and older, relying on hospital administrative data for New York City, by area of residence, from the Statewide Planning and Research Cooperative System (SPARCS). We conduct multiple logistic regressions to analyze the factors associated with revascularization for hospitalized patients admitted with IHD and CHF over the two time periods.Results: Despite any decline in population health status, both the age-adjusted rates of inpatient hospital discharges for acute myocardial infarction, for IHD and for CHF, decreased as did the rates of revascularization procedures. Racial and ethnic disparities were much smaller in the later period than those documented earlier. However, there were persistent gender, insurance status, and neighborhood-level disparities in the treatment of heart disease.Conclusions: With the declines in rates of heart disease, our findings point to the need for more clinical and population-based research to improve the understanding of why race/ethnicity, gender, insurance status, and neighborhood-level disparities persist in the treatment of heart disease.
Highlights
There has been a striking decline in coronary artery disease (CAD) mortality over the past four decades, but it remains the leading cause of death in the United States.[1,2] Much of this decline is attributable to public health interventions, reductions in tobacco use[3] as well as education strategies related to hypertension, diabetes, avoiding dietary trans fat, and obesity.Along with these efforts, the treatment of heart disease has contributed to reductions in mortality.[4,5,6] For many patients with CAD, the provision of anti-antigal medications and medications to modify atherosclerosis has improved outcomes.[7]
Based on analysis for the period 2011–2013, we examine whether disparities in access to revascularization in New York City (NYC) have narrowed
Data To identify the number of hospitalizations for patients with diagnoses of ischemic heart disease (IHD) and/or congestive heart failure (CHF) and the number of revascularizations performed on the population 45 years and older, we rely on hospital administrative data for NYC, by area of residence, from the Statewide Planning and Research Cooperative System (SPARCS), a comprehensive inpatient hospital patient data system established in 1979 by the New York State Department of Health in cooperation with hospitals
Summary
There has been a striking decline in coronary artery disease (CAD) mortality over the past four decades, but it remains the leading cause of death in the United States.[1,2] Much of this decline is attributable to public health interventions, reductions in tobacco use[3] as well as education strategies related to hypertension, diabetes, avoiding dietary trans fat, and obesity.Along with these efforts, the treatment of heart disease has contributed to reductions in mortality.[4,5,6] For many patients with CAD, the provision of anti-antigal medications and medications to modify atherosclerosis has improved outcomes.[7]. There has been a striking decline in coronary artery disease (CAD) mortality over the past four decades, but it remains the leading cause of death in the United States.[1,2] Much of this decline is attributable to public health interventions, reductions in tobacco use[3] as well as education strategies related to hypertension, diabetes, avoiding dietary trans fat, and obesity.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
