Elsevier

Public Health

Volume 110, Issue 1, January 1996, Pages 7-12
Public Health

Age and sex differences in the management of ischaemic heart disease

https://doi.org/10.1016/S0033-3506(96)80027-8Get rights and content

Abstract

Objective

To investigate age and sex differences in the utilisation of hospital services for ischaemic heart disease.

Design

Analysis of routine mortality data and hospital activity data.

Setting

South West Thames Regional Health Authority.

Subjects

Residents of the South West Thames Regional Health Authority who in 1991 either died from ischaemic heart disease or were admitted to an NHS hospital in England and Wales with a main diagnosis of ischaemic heart disease.

Main outcome measures

Ratio of consultant episodes to deaths from ischaemic heart disease (as a proxymeasure of the utilisation of hospital care), and the percentages of consultant episodes in which further investigation (angiography or catheterisation) or revascularisation treatment (coronary artery bypass grafting or angioplasty) were carried out.

Results

The ratio of episodes to deaths was similar in men and women (odds ratio for men vs. women 0.96, 95% confidence intervals 0.90 to 1.03). The percentage of episodes in which further investigation was carried out was higher in men than women (odds ratio for men vs. women 1.46, 95% confidence intervals 1.25 to 1.70) as was the percentage of episodes in which revascularisation treatment was carried out (odds ratio for men vs. women 1.46, 95% confidence intervals 1.20 to 1.77). The ratio of episodes to deaths, the percentage of episodes in which further investigation was carried out, and the percentage of episodes in which revascularisation treatment was carried out all declined with age (all p values <0.001).

Conclusions

Women with ischaemic heart disease are as likely as men to be admitted to hospital, but afteradmission are less likely to undergo further investigation and revascularisation treatment. Elderly patients with ischaemic heart disease are less likely than younger patients to be admitted to hospital; after admission, they are also less likely to undergo further investigation and revascularisation treatment. Further research is needed to determine whether these age and sex differences in the use of hospital services are clinically justified.

References (34)

  • KeeF

    Access to coronary catheterisation: fair shares for all?

    BMJ

    (1993)
  • PetticrewM et al.

    Coronary artery surgery: are women discriminated against

    BMJ

    (1993)
  • MajeedFA

    Monitoring and promoting equity in primary and secondary care

    BMJ

    (1994)
  • BullAR

    Perspectives on the assessment of need

    Journal of Public Health and Medicine

    (1990)
  • PledgerG

    Coronary heart disease: A concise guide for district health authorities and family health service authorities

    (1991)
  • Office of Population Censuses and Surveys

    Mortality statistics: area

    (1991)
  • Cited by (26)

    • What are we counting with hospital episode statistics (hes)?

      2018, Managing Quality: Strategic Issues in Health Care Management
    View all citing articles on Scopus
    View full text