Inequalities in access to and outcomes of cardiac surgery in England: retrospective analysis of Hospital Episode Statistics (2010–2019)

BackgroundWe aimed to characterise the variation in access to and outcomes of cardiac surgery for people in England.MethodsWe included people >18 years of age with hospital admission for ischaemic heart disease (IHD) and heart valve disease (HVD) between 2010 and 2019. Within these populations, w...

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Vydáno v:Heart (British Cardiac Society) Ročník 110; číslo 21; s. 1262 - 1269
Hlavní autoři: Lai, Florence Y, Gibbison, Ben, O’Cathain, Alicia, Akowuah, Enoch, Cleland, John G, Angelini, Gianni D, King, Christina, Murphy, Gavin J, Pufulete, Maria
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ Publishing Group Ltd and British Cardiovascular Society 01.11.2024
BMJ Publishing Group LTD
BMJ Publishing Group
Témata:
Age
Aged
Aged, 80 and over
Aortic and Vascular Disease
Binomial distribution
Cardiac surgery
Cardiac Surgical Procedures
Cardiac Surgical Procedures - mortality
Cardiac Surgical Procedures - statistics & numerical data
Cardiovascular disease
Coronary Artery Bypass
Coronary Artery Bypass - mortality
Coronary Artery Bypass - statistics & numerical data
Electronic Health Records
England - epidemiology
Ethnicity
Female
Frailty
Health Services Accessibility - statistics & numerical data
Healthcare Disparities - ethnology
Healthcare Disparities - statistics & numerical data
Heart failure
Heart surgery
Heart Valve Diseases - mortality
Heart Valve Diseases - surgery
Heart Valve Prosthesis Implantation
Hospital Mortality - trends
Hospitals
Humans
Ischemia
Male
Middle Aged
Missing data
Mortality
Myocardial Ischemia - mortality
Myocardial Ischemia - surgery
Original Research
Patient admissions
Patient Readmission - statistics & numerical data
Regression analysis
Retrospective Studies
Socioeconomic Factors
Socioeconomic status
Transient ischemic attack
Variables
England
United Kingdom > UK
Coronary Artery Bypass
Cardiac Surgical Procedures
Heart Valve Prosthesis Implantation
Cardiac surgery
Electronic Health Records
ISSN:1355-6037, 1468-201X, 1468-201X
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Shrnutí:BackgroundWe aimed to characterise the variation in access to and outcomes of cardiac surgery for people in England.MethodsWe included people >18 years of age with hospital admission for ischaemic heart disease (IHD) and heart valve disease (HVD) between 2010 and 2019. Within these populations, we identified people who had coronary artery bypass graft (CABG) and/or valve surgery, respectively. We fitted logistic regression models to examine the effects of age, sex, ethnicity and socioeconomic deprivation on having access to surgery and in-hospital mortality, 1-year mortality and hospital readmission.ResultsWe included 292 140 people, of whom 28% were women, 11% were from an ethnic minority and 17% were from the most deprived areas. Across all types of surgery, one in five people are readmitted to hospital within 1 year, rising to almost one in four for valve surgery. Women, black people and people living in the most deprived areas were less likely to have access to surgery (CABG: 59%, 32% and 35% less likely; valve: 31%, 33% and 39% less likely, respectively) and more likely to die within 1 year of surgery (CABG: 24%, 85% and 18% more likely, respectively; valve: 19% (women) and 10% (people from most deprived areas) more likely).ConclusionsFemale sex, black ethnicity and economic deprivation are independently associated with limited access to cardiac surgery and higher post-surgery mortality. Actions are required to address these inequalities.
Bibliografie:Original research
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Additional supplemental material is published online only. To view, please visit the journal online (https://doi.org/10.1136/heartjnl-2024-324292).
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.
None declared.
ISSN:1355-6037
1468-201X
1468-201X
DOI:10.1136/heartjnl-2024-324292