BACKGROUND: In China, low socioeconomic status (SES) may be a barrier for patients with coronary heart disease (CHD) to receive adequate treatment because of their inadequate access to health resources. This study aims to evaluate whether and to what extent SES is associated with the treatment of CHD patients. METHODS: A cross-sectional survey was conducted among 2,803 CHD outpatients, a representative sample of China. An SES composite index was derived based on educational levels, monthly income, occupation, and access to medical insurance for each patient. The association between SES and treatment status of several key medications was analyzed. RESULTS: In total, 2,278 CHD outpatients with complete SES information were studied. The treatment rates of clopidogrel and statins were 6.7% and 34.2% in patients with the lowest SES and 41.7% and 75% in patients with the highest SES. In multiple logistic regression analyses, SES was independently associated with the use of aspirin, clopidogrel, statins and beta-blockers. Compared with the patients with the highest SES, the patients with the lowest SES had a 43.4% lower treatment rate for aspirin, a 76% lower rate for clopidogrel, a 70.2% lower rate for statins, and a 70.2% lower rate for beta-blockers after adjustment for various cofactors. CONCLUSIONS: Socioeconomic status is closely associated with the treatment status of secondary prevention in CHD high-risk patients in China. Policy makers and medical professionals urgently need to develop policies and strategies to improve medical care for patients of low SES.
BACKGROUND: In China, low socioeconomic status (SES) may be a barrier for patients with coronary heart disease (CHD) to receive adequate treatment because of their inadequate access to health resources. This study aims to evaluate whether and to what extent SES is associated with the treatment of CHD patients. METHODS: A cross-sectional survey was conducted among 2,803 CHD outpatients, a representative sample of China. An SES composite index was derived based on educational levels, monthly income, occupation, and access to medical insurance for each patient. The association between SES and treatment status of several key medications was analyzed. RESULTS: In total, 2,278 CHD outpatients with complete SES information were studied. The treatment rates of clopidogrel and statins were 6.7% and 34.2% in patients with the lowest SES and 41.7% and 75% in patients with the highest SES. In multiple logistic regression analyses, SES was independently associated with the use of aspirin, clopidogrel, statins and beta-blockers. Compared with the patients with the highest SES, the patients with the lowest SES had a 43.4% lower treatment rate for aspirin, a 76% lower rate for clopidogrel, a 70.2% lower rate for statins, and a 70.2% lower rate for beta-blockers after adjustment for various cofactors. CONCLUSIONS: Socioeconomic status is closely associated with the treatment status of secondary prevention in CHD high-risk patients in China. Policy makers and medical professionals urgently need to develop policies and strategies to improve medical care for patients of low SES.
Authors: Neeta Thakur; Sam S Oh; Elizabeth A Nguyen; Melissa Martin; Lindsey A Roth; Joshua Galanter; Christopher R Gignoux; Celeste Eng; Adam Davis; Kelley Meade; Michael A LeNoir; Pedro C Avila; Harold J Farber; Denise Serebrisky; Emerita Brigino-Buenaventura; William Rodriguez-Cintron; Rajesh Kumar; L Keoki Williams; Kirsten Bibbins-Domingo; Shannon Thyne; Saunak Sen; Jose R Rodriguez-Santana; Luisa N Borrell; Esteban G Burchard Journal: Am J Respir Crit Care Med Date: 2013-11-15 Impact factor: 21.405
Authors: Neeta Thakur; Melissa Martin; Elizabeth Castellanos; Sam S Oh; Lindsey A Roth; Celeste Eng; Emerita Brigino-Buenaventura; Adam Davis; Kelley Meade; Michael A LeNoir; Harold J Farber; Shannon Thyne; Saunak Sen; Kirsten Bibbins-Domingo; Luisa N Borrell; Esteban G Burchard Journal: J Asthma Date: 2014-05-14 Impact factor: 2.515
Authors: Vasilios G Athyros; Thomas D Gossios; Niki Katsiki; Asterios Karagiannis; Dimitri P Mikhailidis Journal: Arch Med Sci Date: 2012-02-29 Impact factor: 3.318
Authors: Dongfeng Gu; Jiang He; Pamela G Coxson; Petra W Rasmussen; Chen Huang; Anusorn Thanataveerat; Keane Y Tzong; Juyang Xiong; Miao Wang; Dong Zhao; Lee Goldman; Andrew E Moran Journal: PLoS Med Date: 2015-08-04 Impact factor: 11.069