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

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  • 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
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    1. 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.
    2. 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.
    3. 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.
    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. 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.
    6. 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.
    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.
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    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. 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.

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