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Health Inequality Among Older Adults with Percutaneous Coronary Intervention and Universal Health Coverage in Japan.
- Source :
-
Population Health Management . Feb2022, Vol. 25 Issue 1, p23-30. 8p. - Publication Year :
- 2022
-
Abstract
- This study aimed to comprehensively evaluate whether income affects long-term health outcomes for older patients who underwent percutaneous coronary intervention (PCI) provided by a universal health coverage system. Data were from the Latter Stage Elderly Healthcare Insurance database in Fukuoka Prefecture, Japan. A total of 5625 individuals aged ≥65 years who underwent PCI in 2014–2016 were included. Cox proportional hazards models were used to assess the association between income status and the incidence of health outcomes. With a median follow-up of 1095 days, 554 acute myocardial infarction (AMI) cases, 1075 stroke cases, 1690 repeat revascularization cases, and 1094 deaths were observed. Risk of all-cause mortality decreased significantly with increasing income level in both unadjusted and adjusted Cox regression models. Patients in the low-income level had a significantly higher rate of AMI (log-rank P = 0.003), stroke (log-rank P = 0.039), and all-cause mortality (log-rank P = 0.001) compared with patients in the high-income level. Observed rates for repeat revascularization also were high in the first year after PCI. In the Japanese universal health setting, low-income patients had a comparatively higher mortality risk after PCI. Poor long-term outcomes might be attributed to patients' baseline characteristics rather than treatment processes. [ABSTRACT FROM AUTHOR]
- Subjects :
- *EVALUATION of medical care
*HEALTH services accessibility
*PERCUTANEOUS coronary intervention
*NOSOLOGY
*CONFIDENCE intervals
*MORTALITY
*LOG-rank test
*RETROSPECTIVE studies
*COMPARATIVE studies
*NATIONAL health insurance
*DESCRIPTIVE statistics
*HEALTH insurance
*CHI-squared test
*KAPLAN-Meier estimator
*DATA analysis software
*PROPORTIONAL hazards models
*LONGITUDINAL method
Subjects
Details
- Language :
- English
- ISSN :
- 19427891
- Volume :
- 25
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Population Health Management
- Publication Type :
- Academic Journal
- Accession number :
- 155019926
- Full Text :
- https://doi.org/10.1089/pop.2021.0070