Disparities in stroke preventive care in general practice did not explain socioeconomic disparities in stroke.

Details

Serval ID
serval:BIB_10ED25847663
Type
Article: article from journal or magazin.
Collection
Publications
Title
Disparities in stroke preventive care in general practice did not explain socioeconomic disparities in stroke.
Journal
Journal of clinical epidemiology
Author(s)
Avendano M., Boshuizen H.C., Schellevis F.G., Mackenbach J.P., Van Lenthe F.J., Van den Bos G.A.
ISSN
0895-4356 (Print)
ISSN-L
0895-4356
Publication state
Published
Issued date
12/2006
Peer-reviewed
Oui
Volume
59
Number
12
Pages
1285-1294
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
To assess socioeconomic disparities in stroke incidence and in the quality of preventive care for stroke in the Netherlands.
A total of 190,664 patients who registered in 96 general practices were followed up for 12 months. Data were collected on diagnoses, referrals, prescriptions, and diagnostic procedures. Hazard ratios (HR) were calculated to assess the association between educational level and stroke incidence. Multilevel logistic regression was used to assess socioeconomic disparities in the quality of preventive care for stroke precursors.
Lower educational level was associated with higher incidence of stroke in men (HR=1.36, 95% CI=1.06-1.74) but not in women. Among both men and women, there were socioeconomic disparities in the prevalence of hypertension, hypercholesterolemia, diabetes, angina pectoris, heart failure, and peripheral artery disease. Lower educated hypercholesterolemia patients under medication were less likely to be prescribed statins (odds ratio=0.62, 95% CI=0.42-0.91). However, for other precursors of stroke, there were no major disparities in the quality of preventive care.
There are socioeconomic disparities in stroke incidence among men but not among women. Socioeconomic differences in factors such as hypertension and diabetes are likely to contribute to stroke disparities. However, general practitioners (GPs) provide care of a similar quality to patients from different socioeconomic groups.
Keywords
Adult, Aged, Angiotensin-Converting Enzyme Inhibitors/therapeutic use, Blood Pressure/physiology, Cardiovascular Diseases/drug therapy, Cardiovascular Diseases/epidemiology, Diuretics/therapeutic use, Educational Status, Family Practice/standards, Female, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use, Incidence, Male, Middle Aged, Netherlands/epidemiology, Prevalence, Quality of Health Care/standards, Risk Factors, Sex Distribution, Stroke/epidemiology, Stroke/prevention & control
Pubmed
Web of science
Create date
18/10/2021 13:59
Last modification date
04/11/2021 6:40
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