RT Journal Article
SR Electronic
T1 <span hwp:id="article-title-1" class="article-title">Influence of practices' ethnicity and deprivation on access to angiography: an ecological study</span><span hwp:id="article-title-25" class="sub-article-title">Commentary</span>
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 423
OP 428
VO 54
IS 503
A1 Melvyn Jones
A1 Alan A Montgomery
A1 Jean Ramsay
A1 Gene Feder
A1 Angela M Crook
A1 Harry Hemingway
YR 2004
UL http://bjgp.org/content/54/503/423.abstract
AB Background: Coronary heart disease is more common among some ethnic minority groups (particularly people from the Indian sub-continent living in Europe and North America) and in socially deprived populations. Hospital studies in the United Kingdom (UK) suggest that these groups have less access to treatment for coronary heart disease. Studies from primary care have found reduced access to angiography for lower social class groups, but there are no studies on the ethnicity of primary care populations in relation to angiography.Aims: To determine the influence of ethnicity and social deprivation in primary care on access to coronary angiography.Design of study: Ecological study measuring general practices' ethnicity, socioeconomic status, and nitrate prescribing rates with angiography rates.Setting: General practices (n = 143) in East London, UK.Method: Ecological study measuring the proportion of general practice populations with South Asian ethnicity and high social deprivation score (Carstairs). Nitrate prescriptions and admissions for myocardial infarction per 1000 population per year were used as measures of need. Distance from the tertiary centre was used as a measure of supply. The outcome measure was coronary angiography procedures data (n = 869) collected in the context of the appropriateness of coronary revascularisation study.Results: Practices with a higher proportion of South Asian patients had higher rates of angiography after adjustment for age, distance, deprivation, nitrate prescribing and myocardial infarction admissions (regression coefficient B = 0.02, 95% confidence interval [CI] = 0.01 to 0.03, P&lt;0.001). There was no association between deprivation and angiography (regression coefficient B = −0.41, 95% CI = −0.13 to 0.05, P = 0.393).Conclusion: General practices with a higher proportion of South Asian patients had higher rates of angiography, challenging the widely held belief that access may be inequitable. Deprivation shows no relationship with angiography in this study.Commentary