RT Journal Article
SR Electronic
T1 Health inequalities in hospitalisation and mortality in patients diagnosed with heart failure in a universal healthcare coverage system
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 845
OP 851
DO 10.1136/jech-2017-210146
VO 72
IS 9
A1 Raquel Garcia
A1 Rosa Abellana
A1 Jordi Real
A1 José-Luis del Val
A1 Jose Maria Verdú-Rotellar
A1 Miguel-Angel Muñoz
YR 2018
UL http://jech.bmj.com/content/72/9/845.abstract
AB Background Information regarding the effect of social determinants of health on heart failure (HF) community-dwelling patients is scarce. We aimed to analyse the presence of socioeconomic inequalities, and their impact on hospitalisations and mortality, in patients with HF attended in a universal healthcare coverage system.Methods A retrospective cohort study carried out in patients with HF aged >40 and attended at the 53 primary healthcare centres of the Institut Català de la Salut in Barcelona (Spain). Socioeconomic status (SES) was determined by an aggregated deprivation index (MEDEA). Cox proportional hazard models and competing-risks regression based on Fine and Gray’s proportional subhazards were performed to analyse hospitalisations due to of HF and total mortality that occurred between 1 January 2009 and 31 December 2012.Results Mean age was 78.1 years (SD 10.2) and 56% were women. Among the 8235 patients included, 19.4% died during the 4 years of follow-up and 27.1% were hospitalised due to HF. A gradient in the risk of hospitalisation was observed according to SES with the highest risk in the lowest socioeconomic group (sHR 1.46, 95% CI 1.27 to 1.68). Nevertheless, overall mortality did not differ among the socioeconomic groups.Conclusions In spite of finding a gradient that linked socioeconomic deprivation to an increased risk of hospitalisation, there were no differences in mortality regarding SES in a universal healthcare coverage system.