Background Universal health care systems seek to ensure accessto care on the basis of need rather than income and to improvethe health status of all citizens. We examined the performanceof the Canadian health system with respect to these goals inthe province of Ontario by assessing the effects of neighborhoodincome on access to invasive cardiac procedures and on mortalityone year after acute myocardial infarction.
Methods We linked claims for payment for physicians' services,hospital-discharge abstracts, and vital-status data for allpatients with acute myocardial infarction who were admittedto hospitals in Ontario between April 1994 and March 1997. Patients'income levels were imputed from the median incomes of theirresidential neighborhoods as determined in Canada's 1996 census.We determined rates of use and waiting times for coronary angiographyand revascularization procedures after the index admission foracute myocardial infarction and determined death rates at oneyear. In multivariate analyses, we controlled for the patient'sage, sex, and severity of disease; the specialty of the attendingphysician; the volume of cases, teaching status, and on-sitefacilities for cardiac procedures at the admitting hospital;and the geographic proximity of the admitting hospital to tertiarycare centers.
Results The study cohort consisted of 51,591 patients. Withrespect to coronary angiography, increases in neighborhood incomefrom the lowest to the highest quintile were associated witha 23 percent increase in rates of use and a 45 percent decreasein waiting times. There was a strong inverse relation betweenincome and mortality at one year (P<0.001). Each $10,000increase in the neighborhood median income was associated witha 10 percent reduction in the risk of death within one year(adjusted hazard ratio, 0.90; 95 percent confidence interval,0.86 to 0.94).
Conclusions In the province of Ontario, despite Canada's universalhealth care system, socioeconomic status had pronounced effectson access to specialized cardiac services as well as on mortalityone year after acute myocardial infarction.
Source Information
From the Institute for Clinical Evaluative Sciences (D.A.A., C.D.N., P.A., J.V.T.); the Clinical Epidemiology and Health Care Research Program (C.D.N., J.V.T.) and the Divisions of Cardiology (D.A.A.) and General Internal Medicine (C.D.N., J.V.T.), Sunnybrook and Women's College Health Sciences Centre and the University of Toronto; and the Department of Public Health Sciences (C.D.N., P.A., J.V.T.) and the Dean's Office (C.D.N.), University of Toronto — all in Toronto.
Address reprint requests to Dr. Tu at the Institute for Clinical Evaluative Sciences, G-106, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada.
Agabiti, N, Cesaroni, G, Picciotto, S, Bisanti, L, Caranci, N, Costa, G, Forastiere, F, Marinacci, C, Pandolfi, P, Russo, A, Perucci, C A, on behalf of the Italian Study Group on Inequaliti,
(2008). The association of socioeconomic disadvantage with postoperative complications after major elective cardiovascular surgery. J. Epidemiol. Community Health
62: 882-889
[Abstract][Full Text]
Rosvall, M., Gerward, S., Engstrom, G., Hedblad, B.
(2008). Income and short-term case fatality after myocardial infarction in the whole middle-aged population of Malmo, Sweden. Eur J Public Health
18: 533-538
[Abstract][Full Text]
Zaman, M. J. MBBS MSc, Junghans, C. PhD, Sekhri, N. MBBS, Chen, R. MD PhD, Feder, G. S. MD, Timmis, A. D. MBBChir MD, Hemingway, H. MBBChir
(2008). Presentation of stable angina pectoris among women and South Asian people. CMAJ
179: 659-667
[Abstract][Full Text]
Krumholz, H. M.
(2008). Outcomes Research: Generating Evidence for Best Practice and Policies. Circulation
118: 309-318
[Full Text]
Sekhri, N., Timmis, A., Chen, R., Junghans, C., Walsh, N., Zaman, J., Eldridge, S., Hemingway, H., Feder, G.
(2008). Inequity of access to investigation and effect on clinical outcomes: prognostic study of coronary angiography for suspected stable angina pectoris. BMJ
336: 1058-1061
[Abstract][Full Text]
Jackevicius, C. A., Li, P., Tu, J. V.
(2008). Prevalence, Predictors, and Outcomes of Primary Nonadherence After Acute Myocardial Infarction. Circulation
117: 1028-1036
[Abstract][Full Text]
Hussey, P., Anderson, G., Berthelot, J.-M., Feek, C., Kelley, E., Osborn, R., Raleigh, V., Epstein, A.
(2008). Trends in socioeconomic disparities in health care quality in four countries. Int J Qual Health Care
20: 53-61
[Abstract][Full Text]
Coory, M., Duckett, S., Sketcher-Baker, K.
(2008). Using control charts to monitor quality of hospital care with administrative data. Int J Qual Health Care
20: 31-39
[Abstract][Full Text]
Bagger, J P, Edwards, M-B, Taylor, K M
(2008). Influence of socioeconomic status on survival after primary aortic or mitral valve replacement. Heart
94: 182-185
[Abstract][Full Text]
Bernheim, S. M., Ross, J. S., Krumholz, H. M., Bradley, E. H.
(2008). Influence of Patients' Socioeconomic Status on Clinical Management Decisions: A Qualitative Study. Ann Fam Med
6: 53-59
[Abstract][Full Text]
Rasmussen, J. N, Gislason, G. H, Rasmussen, S., Abildstrom, S. Z, Schramm, T. K, Kober, L., Diderichsen, F., Osler, M., Torp-Pedersen, C., Madsen, M.
(2007). Use of statins and beta-blockers after acute myocardial infarction according to income and education. J. Epidemiol. Community Health
61: 1091-1097
[Abstract][Full Text]
Kaul, P. PhD, Chang, W.-C. PhD, Westerhout, C. M. MSc, Graham, M. M. MD, Armstrong, P. W. MD
(2007). Differences in admission rates and outcomes between men and women presenting to emergency departments with coronary syndromes. CMAJ
177: 1193-1199
[Abstract][Full Text]
Coory, M., Scott, I.
(2007). Analysing low-risk patient populations allows better discrimination between high-performing and low-performing hospitals: a case study using inhospital mortality from acute myocardial infarction. Qual Saf Health Care
16: 324-328
[Abstract][Full Text]
James, P. D, Wilkins, R., Detsky, A. S, Tugwell, P., Manuel, D. G
(2007). Avoidable mortality by neighbourhood income in Canada: 25 years after the establishment of universal health insurance. J. Epidemiol. Community Health
61: 287-296
[Abstract][Full Text]
Rahimi, A. R., Spertus, J. A., Reid, K. J., Bernheim, S. M., Krumholz, H. M.
(2007). Financial Barriers to Health Care and Outcomes After Acute Myocardial Infarction. JAMA
297: 1063-1072
[Abstract][Full Text]
Pilote, L., Dasgupta, K., Guru, V., Humphries, K. H., McGrath, J., Norris, C., Rabi, D., Tremblay, J., Alamian, A., Barnett, T., Cox, J., Ghali, W. A., Grace, S., Hamet, P., Ho, T., Kirkland, S., Lambert, M., Libersan, D., O'Loughlin, J., Paradis, G., Petrovich, M., Tagalakis, V.
(2007). A comprehensive view of sex-specific issues related to cardiovascular disease. CMAJ
176: S1-S44
[Abstract][Full Text]
Kisely, S., Smith, M., Lawrence, D., Cox, M., Campbell, L. A., Maaten, S.
(2007). Inequitable access for mentally ill patients to some medically necessary procedures. CMAJ
176: 779-784
[Abstract][Full Text]
Denvir, M A, Lee, A J, Rysdale, J, Walker, A, Eteiba, H, Starkey, I R, Pell, J P
(2006). Influence of socioeconomic status on clinical outcomes and quality of life after percutaneous coronary intervention.. J. Epidemiol. Community Health
60: 1085-1088
[Abstract][Full Text]
Manderbacka, K., Hetemaa, T., Keskimaki, I., Luukkainen, P., Koskinen, S., Reunanen, A.
(2006). Are there socioeconomic differences in myocardial infarction event rates and fatality among patients with angina pectoris?. J. Epidemiol. Community Health
60: 442-447
[Abstract][Full Text]
Rasmussen, J. N, Rasmussen, S., Gislason, G. H, Buch, P., Abildstrom, S. Z, Kober, L., Osler, M., Diderichsen, F., Torp-Pedersen, C., Madsen, M.
(2006). Mortality after acute myocardial infarction according to income and education.. J. Epidemiol. Community Health
60: 351-356
[Abstract][Full Text]
Park-Wyllie, L. Y., Juurlink, D. N., Kopp, A., Shah, B. R., Stukel, T. A., Stumpo, C., Dresser, L., Low, D. E., Mamdani, M. M.
(2006). Outpatient Gatifloxacin Therapy and Dysglycemia in Older Adults. NEJM
354: 1352-1361
[Abstract][Full Text]
Steele, L. S., Glazier, R. H., Lin, E.
(2006). Inequity in Mental Health Care Under Canadian Universal Health Coverage. Psychiatr. Serv.
57: 317-324
[Abstract][Full Text]
Hetemaa, T., Manderbacka, K., Reunanen, A., Koskinen, S., Keskimaki, I.
(2006). Socioeconomic inequities in invasive cardiac procedures among patients with incident angina pectoris or myocardial infarction. Scand J Public Health
34: 116-123
[Abstract]
Joseph, K. S., Dodds, L., Allen, A. C., Jones, D. V., Monterrosa, L., Robinson, H., Liston, R. M., Young, D. C.
(2006). Socioeconomic Status and Receipt of Obstetric Services in Canada.. Obstet Gynecol
107: 641-650
[Abstract][Full Text]
Alter, D. A., Stukel, T. A., Newman, A.
(2006). Proliferation of Cardiac Technology in Canada: A Challenge to the Sustainability of Medicare. Circulation
113: 380-387
[Abstract][Full Text]
van Doorslaer, E., Masseria, C., Koolman, X., for the OECD Health Equity Research Group,
(2006). Inequalities in access to medical care by income in developed countries. CMAJ
174: 177-183
[Abstract][Full Text]
Hurley, J., Grignon, M.
(2006). Income and equity of access to physician services. CMAJ
174: 187-188
[Full Text]
Alter, D. A., Chong, A., Austin, P. C., Mustard, C., Iron, K., Williams, J. I., Morgan, C. D., Tu, J. V., Irvine, J., Naylor, C. D., for the SESAMI Study Group*,
(2006). Socioeconomic Status and Mortality after Acute Myocardial Infarction. ANN INTERN MED
144: 82-93
[Abstract][Full Text]
Picciotto, S., Forastiere, F., Stafoggia, M., D'Ippoliti, D., Ancona, C., Perucci, C. A
(2006). Associations of area based deprivation status and individual educational attainment with incidence, treatment, and prognosis of first coronary event in Rome, Italy. J. Epidemiol. Community Health
60: 37-43
[Abstract][Full Text]
Manderbacka, K.
(2005). Exploring gender and socioeconomic differences in treatment of coronary heart disease. Eur J Public Health
15: 634-639
[Abstract][Full Text]
Pickett, K. E., Luo, Y., Lauderdale, D. S.
(2005). Widening Social Inequalities in Risk for Sudden Infant Death Syndrome. Am. J. Public Health
95: 1976-1981
[Abstract][Full Text]
Bootsma-van der Wiel, A., de Craen, A. J.M., Van Exel, E., Macfarlane, P. W., Gussekloo, J., Westendorp, R. G.J.
(2005). Association between chronic diseases and disability in elderly subjects with low and high income: the Leiden 85-plus Study. Eur J Public Health
15: 494-497
[Abstract][Full Text]
Lee, D. S., Tu, J. V., Juurlink, D. N., Alter, D. A., Ko, D. T., Austin, P. C., Chong, A., Stukel, T. A., Levy, D., Laupacis, A.
(2005). Risk-Treatment Mismatch in the Pharmacotherapy of Heart Failure. JAMA
294: 1240-1247
[Abstract][Full Text]
Tonne, C., Schwartz, J., Mittleman, M., Melly, S., Suh, H., Goldberg, R.
(2005). Long-Term Survival After Acute Myocardial Infarction Is Lower in More Deprived Neighborhoods. Circulation
111: 3063-3070
[Abstract][Full Text]
Spenceley, S. M.
(2005). Access to Health Services by Canadians Who Are Chronically Ill. West J Nurs Res
27: 465-486
[Abstract]
Lee, T. C., Hanlon, J. G., Ben-David, J., Booth, G. L., Cantor, W. J., Connelly, P. W., Hwang, S. W.
(2005). Risk Factors for Cardiovascular Disease in Homeless Adults. Circulation
111: 2629-2635
[Abstract][Full Text]
Hackam, D. G., Kopp, A., Redelmeier, D. A.
(2005). Prognostic Implications of Warfarin Cessation After Major Trauma: A Population-Based Cohort Analysis. Circulation
111: 2250-2256
[Abstract][Full Text]
Morris, R W, Whincup, P H, Papacosta, O, Walker, M, Thomson, A
(2005). Inequalities in coronary revascularisation during the 1990s: evidence from the British regional heart study. Heart
91: 635-640
[Abstract][Full Text]
Willems, S. J, Swinnen, W., De Maeseneer, J. M
(2005). The GP's perception of poverty: a qualitative study. Fam Pract
22: 177-183
[Abstract][Full Text]
Sonel, A. F., Good, C. B., Mulgund, J., Roe, M. T., Gibler, W. B., Smith, S. C. Jr, Cohen, M. G., Pollack, C. V. Jr, Ohman, E. M., Peterson, E. D., for the CRUSADE Investigators,
(2005). Racial Variations in Treatment and Outcomes of Black and White Patients With High-Risk Non-ST-Elevation Acute Coronary Syndromes: Insights From CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines?). Circulation
111: 1225-1232
[Abstract][Full Text]
Grace, S. L., Abbey, S. E., Pinto, R., Shnek, Z. M., Irvine, J., Stewart, D. E.
(2005). Longitudinal Course of Depressive Symptomatology After a Cardiac Event: Effects of Gender and Cardiac Rehabilitation. Psychosom. Med.
67: 52-58
[Abstract][Full Text]
Desai, N. D., Pelletier, M. P., Mallidi, H. R., Christakis, G. T., Cohen, G. N., Fremes, S. E., Goldman, B. S.
(2004). Why Is Off-Pump Coronary Surgery Uncommon in Canada? Results of a Population-Based Survey of Canadian Heart Surgeons. Circulation
110: II-7-II-12
[Abstract][Full Text]
Martens, P. J., Derksen, S., Gupta, S.
(2004). Predictors of Hospital Readmission of Manitoba Newborns Within Six Weeks Postbirth Discharge: A Population-Based Study. Pediatrics
114: 708-713
[Abstract][Full Text]
Singh, S. M., Paszat, L. F., Li, C., He, J., Vinden, C., Rabeneck, L.
(2004). Association of socioeconomic status and receipt of colorectal cancer investigations: a population-based retrospective cohort study. CMAJ
171: 461-465
[Abstract][Full Text]
Britton, A., Shipley, M., Marmot, M., Hemingway, H.
(2004). Does access to cardiac investigation and treatment contribute to social and ethnic differences in coronary heart disease? Whitehall II prospective cohort study. BMJ
329: 318-
[Abstract][Full Text]
Woo, J. K.H., Ghorayeb, S. H., Lee, C. K., Sangha, H., Richter, S.
(2004). Effect of patient socioeconomic status on perceptions of first- and second-year medical students. CMAJ
170: 1915-1919
[Abstract][Full Text]
Rao, S. V., Schulman, K. A., Curtis, L. H., Gersh, B. J., Jollis, J. G.
(2004). Socioeconomic Status and Outcome Following Acute Myocardial Infarction in Elderly Patients. Arch Intern Med
164: 1128-1133
[Abstract][Full Text]
McAlister, F A, Murphy, N F, Simpson, C R, Stewart, S, MacIntyre, K, Kirkpatrick, M, Chalmers, J, Redpath, A, Capewell, S, McMurray, J J V
(2004). Influence of socioeconomic deprivation on the primary care burden and treatment of patients with a diagnosis of heart failure in general practice in Scotland: population based study. BMJ
328: 1110-
[Abstract][Full Text]
Ko, D. T., Mamdani, M., Alter, D. A.
(2004). Lipid-Lowering Therapy With Statins in High-Risk Elderly Patients: The Treatment-Risk Paradox. JAMA
291: 1864-1870
[Abstract][Full Text]
Guru, V., Fremes, S. E., Tu, J. V.
(2004). Time-related mortality for women after coronary artery bypass graft surgery: A population-based study. J. Thorac. Cardiovasc. Surg.
127: 1158-1165
[Abstract][Full Text]
Alter, D. A., Iron, K., Austin, P. C., Naylor, C. D.
(2004). Socioeconomic Status, Service Patterns, and Perceptions of Care Among Survivors of Acute Myocardial Infarction in Canada. JAMA
291: 1100-1107
[Abstract][Full Text]
Chang, W.-C., Kaul, P., Westerhout, C. M., Graham, M. M., Fu, Y., Chowdhury, T., Armstrong, P. W.
(2003). Impact of Sex on Long-term Mortality From Acute Myocardial Infarction vs Unstable Angina. Arch Intern Med
163: 2476-2484
[Abstract][Full Text]
Taylor, F C, Ascione, R, Rees, K, Narayan, P, Angelini, G D
(2003). Socioeconomic deprivation is a predictor of poor postoperative cardiovascular outcomes in patients undergoing coronary artery bypass grafting. Heart
89: 1062-1066
[Abstract][Full Text]
Alter, D. A., Tu, J. V., Austin, P. C., Naylor, C. D.
(2003). Waiting times, revascularization modality, and outcomes after acute myocardial infarction at hospitals with and without on-site revascularization facilities in Canada. J Am Coll Cardiol
42: 410-419
[Abstract][Full Text]
Sin, D. D., Svenson, L. W., Cowie, R. L., Man, S. F. P.
(2003). Can Universal Access to Health Care Eliminate Health Inequities Between Children of Poor and Nonpoor Families?: A Case Study of Childhood Asthma in Alberta. Chest
124: 51-56
[Abstract][Full Text]
Whalen, J. P.
(2003). Health Care in America: Lost Opportunities Amid Plenty. Qual Health Res
13: 857-870
[Abstract]
Rao, S. V., Kaul, P., Newby, L. K., Lincoff, A. M., Hochman, J., Harrington, R. A., Mark, D. B., Peterson, E. D.
(2003). Poverty, process of care, and outcome in acute coronary syndromes. J Am Coll Cardiol
41: 1948-1954
[Abstract][Full Text]
Douglas Weaver, W., Maynard, C.
(2003). Poverty and mortality in patients with acute coronary syndromes: A search for answers and a call for action. J Am Coll Cardiol
41: 1955-1956
[Full Text]
Shah, B. R., Gunraj, N., Hux, J. E.
(2003). Markers of Access to and Quality of Primary Care for Aboriginal People in Ontario, Canada. Am. J. Public Health
93: 798-802
[Abstract][Full Text]
Alter, D. A., Khaykin, Y., Austin, P. C., Tu, J. V., Hux, J. E.
(2003). Processes and Outcomes of Care for Diabetic Acute Myocardial Infarction Patients in Ontario: Do physicians undertreat?. Diabetes Care
26: 1427-1434
[Abstract][Full Text]
Hetemaa, T, Keskimaki, I, Manderbacka, K, Leyland, A H, Koskinen, S
(2003). How did the recent increase in the supply of coronary operations in Finland affect socioeconomic and gender equity in their use?. J. Epidemiol. Community Health
57: 178-185
[Abstract][Full Text]
Sullivan, M. D., LaCroix, A. Z., Spertus, J. A., Hecht, J., Russo, J.
(2003). Depression Predicts Revascularization Procedures for 5 Years After Coronary Angiography. Psychosom. Med.
65: 229-236
[Abstract][Full Text]
Shortt, S. E.D., Shaw, R. A.
(2003). Equity in Canadian health care: Does socioeconomic status affect waiting times for elective surgery?. CMAJ
168: 413-416
[Abstract][Full Text]
Alter, D. A., Naylor, C. D., Austin, P. C., Chan, B. T.B., Tu, J. V.
(2003). Geography and service supply do not explain socioeconomic gradients in angiography use after acute myocardial infarction. CMAJ
168: 261-264
[Abstract][Full Text]
Booth, G. L., Hux, J. E.
(2003). Relationship Between Avoidable Hospitalizations for Diabetes Mellitus and Income Level. Arch Intern Med
163: 101-106
[Abstract][Full Text]
Khaykin, Y, Austin, P C, Tu, J V, Alter, D A
(2002). Utilisation of coronary angiography after acute myocardial infarction in Ontario over time: have referral patterns changed?. Heart
88: 460-466
[Abstract][Full Text]
Egeland, G. M, Tverdal, A., Meyer, H. E, Selmer, R.
(2002). A man's heart and a wife's education: A 12-year coronary heart disease mortality follow-up in Norwegian men. Int J Epidemiol
31: 799-805
[Abstract][Full Text]
Chang, W-C
(2002). The meaning and goals of equity in health. J. Epidemiol. Community Health
56: 488-491
[Abstract][Full Text]
Steenland, K., Henley, J., Thun, M.
(2002). All-Cause and Cause-specific Death Rates by Educational Status for Two Million People in Two American Cancer Society Cohorts, 1959-1996. Am J Epidemiol
156: 11-21
[Abstract][Full Text]
Rochon, P. A, Bronskill, S. E, Gurwitz, J. H
(2002). Health care for older people. BMJ
324: 1231-1232
[Full Text]
Huang, J., Boyd, C., Tyldesley, S., Zhang-Salomons, J., Groome, P. A., Mackillop, W. J.
(2002). Time Spent in Hospital in the Last Six Months of Life in Patients Who Died of Cancer in Ontario. JCO
20: 1584-1592
[Abstract][Full Text]
Feder, G., Crook, A. M, Magee, P., Banerjee, S., Timmis, A. D, Hemingway, H.
(2002). Ethnic differences in invasive management of coronary disease: prospective cohort study of patients undergoing angiography. BMJ
324: 511-516
[Abstract][Full Text]
Coory, M, Scott, I A, Baade, P
(2002). Differential effect of socioeconomic status on rates of invasive coronary procedures across the public and private sectors in Queensland, Australia. J. Epidemiol. Community Health
56: 233-234
[Full Text]
Steptoe, A., Marmot, M.
(2002). The role of psychobiological pathways in socio-economic inequalities in cardiovascular disease risk. Eur Heart J
23: 13-25
[Full Text]
Kapral, M. K., Wang, H., Mamdani, M., Tu, J. V., Boden-Albala, B., Sacco, R. L.
(2002). Effect of Socioeconomic Status on Treatment and Mortality After Stroke * Editorial Comment. Stroke
33: 268-275
[Abstract][Full Text]
Redelmeier, D. A, Singh, S. M
(2001). Longevity of screenwriters who win an academy award: longitudinal study. BMJ
323: 1491-1496
[Abstract][Full Text]
Rathore, S. S., Chen, J., Wang, Y., Radford, M. J., Vaccarino, V., Krumholz, H. M.
(2001). Sex Differences in Cardiac Catheterization: The Role of Physician Gender. JAMA
286: 2849-2856
[Abstract][Full Text]
Hartmann, A., Rundek, T., Mast, H., Paik, M. C., Boden-Albala, B., Mohr, J. P., Sacco, R. L.
(2001). Mortality and causes of death after first ischemic stroke: The Northern Manhattan Stroke Study. Neurology
57: 2000-2005
[Abstract][Full Text]
SUTHERLAND, C. A., SULLIVAN, C. M., BYBEE, D. I.
(2001). Effects of Intimate Partner Violence Versus Poverty on Women's Health. Violence Against Women
7: 1122-1143
[Abstract]
Katz, J. N.
(2001). Patient Preferences and Health Disparities. JAMA
286: 1506-1509
[Full Text]
Ray, A. A., Buth, K. J., Sullivan, J. A., Johnstone, D. E., Hirsch, G. M.
(2001). Waiting for Cardiac Surgery: Results of a Risk-Stratified Queuing Process. Circulation
104
: I-92-I-98
[Abstract][Full Text]
Finkelstein, M. M.
(2001). Do factors other than need determine utilization of physicians' services in Ontario?. CMAJ
165: 565-570
[Abstract][Full Text]
Upshur, R. E.G., Morin, B., Goel, V.
(2001). The privacy paradox: laying Orwell's ghost to rest. CMAJ
165: 307-309
[Full Text]
Mukamal, K. J., Nesto, R. W., Cohen, M. C., Muller, J. E., Maclure, M., Sherwood, J. B., Mittleman, M. A.
(2001). Impact of Diabetes on Long-Term Survival After Acute Myocardial Infarction: Comparability of risk with prior myocardial infarction. Diabetes Care
24: 1422-1427
[Abstract][Full Text]
Tu, J. V., Austin, P. C., Chan, B. T. B.
(2001). Relationship Between Annual Volume of Patients Treated by Admitting Physician and Mortality After Acute Myocardial Infarction. JAMA
285: 3116-3122
[Abstract][Full Text]
Alter, D. A., Naylor, C. D., Austin, P. C., Tu, J. V.
(2001). Long-term MI Outcomes at Hospitals With or Without On-site Revascularization. JAMA
285: 2101-2108
[Abstract][Full Text]
Birch, S.
(2001). Commentary: Social inequalities in health, social epidemiology and social value. Int J Epidemiol
30: 294-296
[Full Text]
Jackevicius, C. A., Anderson, G. M., Leiter, L., Tu, J. V.
(2001). Use of the Statins in Patients After Acute Myocardial Infarction: Does Evidence Change Practice?. Arch Intern Med
161: 183-188
[Abstract][Full Text]
O'Neill, J., Marconi, K.
(2001). Access to palliative care in the USA: why emphasize vulnerable populations?. JRSM
94: 452-454
[Full Text]
Ancona, C., Agabiti, N., Forastiere, F., Arcà, M., Fusco, D., Ferro, S., Perucci, C. A
(2000). Coronary artery bypass graft surgery: socioeconomic inequalities in access and in 30 day mortality. A population-based study in Rome, Italy. J. Epidemiol. Community Health
54: 930-935
[Abstract][Full Text]
Einbinder, L. C., Schulman, K. A.
(2000). The Effect of Race on the Referral Process for Invasive Cardiac Procedures. Med Care Res Rev
57: 162-180
[Abstract]
Salomaa, V., Niemela, M., Miettinen, H., Ketonen, M., Immonen-Raiha, P., Koskinen, S., Mahonen, M., Lehto, S., Vuorenmaa, T., Palomaki, P., Mustaniemi, H., Kaarsalo, E., Arstila, M., Torppa, J., Kuulasmaa, K., Puska, P., Pyorala, K., Tuomilehto, J.
(2000). Relationship of Socioeconomic Status to the Incidence and Prehospital, 28-Day, and 1-Year Mortality Rates of Acute Coronary Events in the FINMONICA Myocardial Infarction Register Study. Circulation
101: 1913-1918
[Abstract][Full Text]
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