IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v24y2015is2p102-115.html
   My bibliography  Save this article

Socio‐economic Inequality in the Use of Procedures and Mortality Among AMI Patients: Quantifying the Effects Along Different Paths

Author

Listed:
  • Terje P. Hagen
  • Unto Häkkinen
  • Tor Iversen
  • Søren Toksvig Klitkou
  • Tron Anders Moger
  • on behalf of the EuroHOPE study group

Abstract

It is not known whether inequality in access to cardiac procedures translates into inequality in mortality. In this paper, we use a path analysis model to quantify both the direct effect of socio‐economic status on mortality and the indirect effect of socio‐economic status on mortality as mediated by the provision of cardiac procedures. The study links microdata from the Finnish and Norwegian national patient registers describing treatment episodes with data from prescription registers, causes‐of‐death registers and registers covering education and income. We show that socio‐economic variables affect access to percutaneous coronary intervention in both countries, but that these effects are only moderate and that the indirect effects of the socio‐economic factors on mortality through access to percutaneous coronary intervention are minor. The direct effects of income and education on mortality are significantly larger. We conclude that the socio‐economic gradient in the use of percutaneous coronary intervention adds to socio‐economic differences in mortality to little or no extent. Copyright © 2015 John Wiley & Sons, Ltd.

Suggested Citation

  • Terje P. Hagen & Unto Häkkinen & Tor Iversen & Søren Toksvig Klitkou & Tron Anders Moger & on behalf of the EuroHOPE study group, 2015. "Socio‐economic Inequality in the Use of Procedures and Mortality Among AMI Patients: Quantifying the Effects Along Different Paths," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 102-115, December.
  • Handle: RePEc:wly:hlthec:v:24:y:2015:i:s2:p:102-115
    DOI: 10.1002/hec.3269
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.3269
    Download Restriction: no

    File URL: https://libkey.io/10.1002/hec.3269?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Silvia Stringhini & Aline Dugravot & Martin Shipley & Marcel Goldberg & Marie Zins & Mika Kivimäki & Michael Marmot & Séverine Sabia & Archana Singh-Manoux, 2011. "Health Behaviours, Socioeconomic Status, and Mortality: Further Analyses of the British Whitehall II and the French GAZEL Prospective Cohorts," PLOS Medicine, Public Library of Science, vol. 8(2), pages 1-1, February.
    2. Korda, Rosemary J. & Clements, Mark S. & Dixon, Jane, 2011. "Socioeconomic inequalities in the diffusion of health technology: Uptake of coronary procedures as an example," Social Science & Medicine, Elsevier, vol. 72(2), pages 224-229, January.
    3. Cutler, David M. & Lleras-Muney, Adriana, 2010. "Understanding differences in health behaviors by education," Journal of Health Economics, Elsevier, vol. 29(1), pages 1-28, January.
    4. Buchmueller, Thomas C. & Jacobson, Mireille & Wold, Cheryl, 2006. "How far to the hospital?: The effect of hospital closures on access to care," Journal of Health Economics, Elsevier, vol. 25(4), pages 740-761, July.
    5. Mickael Bech & Terkel Christiansen & Kelly Dunham & Jørgen Lauridsen & Carl Hampus Lyttkens & Kathryn McDonald & Alistair McGuire & and the TECH Investigators, 2009. "The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks," Health Economics, John Wiley & Sons, Ltd., vol. 18(10), pages 1114-1132, October.
    6. David A Alter & Barry Franklin & Dennis T Ko & Peter C Austin & Douglas S Lee & Paul I Oh & Therese A Stukel & Jack V Tu, 2013. "Socioeconomic Status, Functional Recovery, and Long-Term Mortality among Patients Surviving Acute Myocardial Infarction," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-10, June.
    7. Terkel Christiansen & Kelly Dunham & Jørgen Lauridsen & Carl Hampus Lyttkens & Kathryn Mcdonald & Alistair Mcguire & Carine Milcent, 2009. "The influence of economic incentives and regulatory factors on the adoption of treatment technologies: a case study of technologies used to treat heart attacks," Post-Print halshs-03168477, HAL.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Dawid Majcherek & Marzenna Anna Weresa & Christina Ciecierski, 2020. "Understanding Regional Risk Factors for Cancer: A Cluster Analysis of Lifestyle, Environment and Socio-Economic Status in Poland," Sustainability, MDPI, vol. 12(21), pages 1-15, October.
    2. Sundararajan, Vijaya & Yang, Ou & Yong, Jongsay, 2023. "Socioeconomic status and access to care in a universal health care system: The case of acute myocardial infarction in Australia," Journal of Economic Behavior & Organization, Elsevier, vol. 215(C), pages 1-25.
    3. Mario Saia & Domenico Mantoan & Marco Fonzo & Chiara Bertoncello & Marta Soattin & Milena Sperotto & Tatjana Baldovin & Patrizia Furlan & Maria Luisa Scapellato & Guido Viel & Vincenzo Baldo & Silvia , 2018. "Impact of the Regional Network for AMI in the Management of STEMI on Care Processes, Outcomes and Health Inequities in the Veneto Region, Italy," IJERPH, MDPI, vol. 15(9), pages 1-14, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kollerup, Anna & Wadmann, Sarah & Bek, Toke & Kjellberg, Jakob, 2022. "National clinical guidelines and treatment centralization do not guarantee consistency in healthcare delivery. A mixed-methods study of wet age-related macular degeneration treatment in Denmark," Health Policy, Elsevier, vol. 126(12), pages 1291-1302.
    2. Maximilian H. M. Hatz & Jonas Schreyögg & Aleksandra Torbica & Giuseppe Boriani & Carl R. B. Blankart, 2017. "Adoption Decisions for Medical Devices in the Field of Cardiology: Results from a European Survey," Health Economics, John Wiley & Sons, Ltd., vol. 26(S1), pages 124-144, February.
    3. Abu-Qarn, Aamer & Lichtman-Sadot, Shirlee, 2022. "Can greater access to secondary health care decrease health inequality? Evidence from bus line introduction to Arab towns in Israel," Economic Modelling, Elsevier, vol. 106(C).
    4. Aleksandra Torbica & Helen Banks & Cinzia Valzania & Giuseppe Boriani & Giovanni Fattore, 2017. "Investigating Regional Variation of Cardiac Implantable Electrical Device Implant Rates in European Healthcare Systems: What Drives Differences?," Health Economics, John Wiley & Sons, Ltd., vol. 26(S1), pages 30-45, February.
    5. Frankovic, Ivan & Kuhn, Michael, 2019. "Access to health care, medical progress and the emergence of the longevity gap: A general equilibrium analysis," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    6. Finocchiaro Castro, Massimo & Guccio, Calogero & Pignataro, Giacomo & Rizzo, Ilde, 2014. "The effects of reimbursement mechanisms on medical technology diffusion in the hospital sector in the Italian NHS," Health Policy, Elsevier, vol. 115(2), pages 215-229.
    7. Patricia Ex & Cornelia Henschke, 2019. "Changing payment instruments and the utilisation of new medical technologies," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(7), pages 1029-1039, September.
    8. Abu-Qarn, Aamer & Lichtman-Sadot, Shirlee, 2021. "Older Adult Health Following Greater Access to Secondary Health Care: Evidence from Bus Service Introductions to Arab Towns in Israel," IZA Discussion Papers 14490, Institute of Labor Economics (IZA).
    9. Liu, Ya-Ming & Kao Yang, Yea-Huei & Hsieh, Chee-Ruey, 2011. "The determinants of the adoption of pharmaceutical innovation: Evidence from Taiwan," Social Science & Medicine, Elsevier, vol. 72(6), pages 919-927, March.
    10. Xidong Guo, 2024. "An analysis of a rural hospital's investment decision under different payment systems," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 714-747, April.
    11. David H. Howard & Yu-Chu Shen, 2011. "Comparative Effectiveness Research, COURAGE, and Technological Abandonment," NBER Working Papers 17371, National Bureau of Economic Research, Inc.
    12. Maynou, L. & McGuire, A. & Serra-Sastre, V., 2019. "Exploring the Impact of New Medical Technology on Workforce Planning," Working Papers 19/07, Department of Economics, City University London.
    13. Maynou, Laia & McGuire, Alistair & Serra-Sastre, Victoria, 2024. "What happens when the tasks dry up? Exploring the impact of medical technology on workforce planning," LSE Research Online Documents on Economics 124065, London School of Economics and Political Science, LSE Library.
    14. Vijaya Sundararajan & Ou Yang & Jongsay Yong, 2023. "Socioeconomic status and access to care in a universal healthcare system: The case of acute myocardial infarction in Australia," Melbourne Institute Working Paper Series wp2023n10, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    15. Köppen, Julia & Maier, Claudia B. & Busse, Reinhard, 2018. "What are the motivating and hindering factors for health professionals to undertake new roles in hospitals? A study among physicians, nurses and managers looking at breast cancer and acute myocardial ," Health Policy, Elsevier, vol. 122(10), pages 1118-1125.
    16. Hyclak, Thomas J. & Skeels, Christopher L. & Taylor, Larry W., 2016. "The cardiovascular revolution and economic performance in the OECD countries," Journal of Macroeconomics, Elsevier, vol. 50(C), pages 114-125.
    17. Mark E McGovern, 2012. "Don't Stress: Early Life Conditions, Hypertension, and Selection into Associated Risk Factors," Working Papers 201227, School of Economics, University College Dublin.
    18. Richard Heijink & Peter Engelfriet & Clas Rehnberg & Sverre A. C. Kittelsen & Unto Häkkinen & on behalf of the EuroHOPE study group, 2015. "A Window on Geographic Variation in Health Care: Insights from EuroHOPE," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 164-177, December.
    19. Michele Bisceglia & Roberto Cellini & Luca Grilli, 2018. "Regional regulators in health care service under quality competition: A game theoretical model," Health Economics, John Wiley & Sons, Ltd., vol. 27(11), pages 1821-1842, November.
    20. Sundararajan, Vijaya & Yang, Ou & Yong, Jongsay, 2023. "Socioeconomic status and access to care in a universal health care system: The case of acute myocardial infarction in Australia," Journal of Economic Behavior & Organization, Elsevier, vol. 215(C), pages 1-25.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:24:y:2015:i:s2:p:102-115. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.