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God vård på lika villkor vid hjärtinfarkt i dagens Sverige. Geografiska skillnader i dödlighet utan betyd [Equally good care of myocardial infarction in Sweden today. Geographic differences in mortality are without significance for the individual patient]

Merlo, Juan LU ; Håkansson, Anders LU ; Beckman, Anders LU ; Lindblad, Ulf LU ; Lindström, Martin LU ; Gerdtham, Ulf LU and Råstam, Lennart LU (2005) In Läkartidningen 102(1-2). p.3-20
Abstract (Swedish)
I TV-programmet »Uppdrag granskning« påstods nyligen

(16 mars 2004) att det är livsviktigt för patienter

med akut hjärtinfarkt att bo i närheten av rätt sjukhus.

Frågan är när geografiska skillnader i dödlighet blir

så pass stora och säkra att de har betydelse för den

enskilda patienten.

När man studerar skillnader i dödlighet mellan olika

sjukhus bör man om möjligt också beakta landstingens

roll.

I detta arbete applicerar vi flernivåanalys för att studera

skillnader i 28-dagarsdödlighet efter förstagångsinfarkt

mellan landsting och mellan sjukhus.

Vi finner att den enskilda infarktpatienten skulle tjäna

väldigt lite på att... (More)
I TV-programmet »Uppdrag granskning« påstods nyligen

(16 mars 2004) att det är livsviktigt för patienter

med akut hjärtinfarkt att bo i närheten av rätt sjukhus.

Frågan är när geografiska skillnader i dödlighet blir

så pass stora och säkra att de har betydelse för den

enskilda patienten.

När man studerar skillnader i dödlighet mellan olika

sjukhus bör man om möjligt också beakta landstingens

roll.

I detta arbete applicerar vi flernivåanalys för att studera

skillnader i 28-dagarsdödlighet efter förstagångsinfarkt

mellan landsting och mellan sjukhus.

Vi finner att den enskilda infarktpatienten skulle tjäna

väldigt lite på att – om det vore möjligt – flytta till ett

annat landsting eller annat sjukhus. De små geografiska

skillnaderna i dödlighet efter hjärtinfarkt tyder

på en god vård på lika villkor i dagens Sverige. (Less)
Abstract
It is a known fact that the 1990s brought a decrease in mortality after myocardial infarction in Sweden but that differences in mortality rates following myocardial infarction still remain between the Swedish counties. Unresolved, however, are questions as to what these inter-county differences mean for the individual patient and what role hospital care plays in this context. We analysed all patients aged 64-85 years who were hospitalised following diagnosis of myocardial infarction in Sweden during the period 1993-1996. To gain an understanding of the relevance of geographical differences in mortality after myocardial infarction for the individual patient we applied multi-level regression analysis and calculated county and hospital median... (More)
It is a known fact that the 1990s brought a decrease in mortality after myocardial infarction in Sweden but that differences in mortality rates following myocardial infarction still remain between the Swedish counties. Unresolved, however, are questions as to what these inter-county differences mean for the individual patient and what role hospital care plays in this context. We analysed all patients aged 64-85 years who were hospitalised following diagnosis of myocardial infarction in Sweden during the period 1993-1996. To gain an understanding of the relevance of geographical differences in mortality after myocardial infarction for the individual patient we applied multi-level regression analysis and calculated county and hospital median odds ratios (MORs) in relation to 28-day mortality. For hospitalised patients with myocardial infarction, being cared for in another hospital with higher mortality would increase the risk of dying by 9% (MOR=1.09) in men and 12% in women. If these patients moved to another county with higher mortality the risk would increase by 7% and 3%, respectively. The small geographical differences in 28-day mortality after myocardial infarction found in Sweden suggest a high degree of equality across the country; however, further improvement could be achieved in hospital care, especially for women - an issue that deserves further analysis. (Less)
Please use this url to cite or link to this publication:
author
organization
alternative title
Equally good care of myocardial infarction in Sweden today. Geographic differences in mortality are without significance for the individual patient
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Odds Ratio, Myocardial Infarction: therapy, Myocardial Infarction: mortality, Middle Aged, Male, Humans, Hospital Mortality, Female, English Abstract, Aged, Comparative Study, Regression Analysis, Sweden: epidemiology, Quality of Health Care
in
Läkartidningen
volume
102
issue
1-2
pages
3 - 20
ISSN
0023-7205
language
Swedish
LU publication?
yes
id
aabc5459-9185-49c2-b9e6-9df2530e04ba (old id 133792)
alternative location
http://ltarkiv.lakartidningen.se/artNo29629
date added to LUP
2007-07-25 10:41:58
date last changed
2016-04-16 03:28:40
@article{aabc5459-9185-49c2-b9e6-9df2530e04ba,
  abstract     = {It is a known fact that the 1990s brought a decrease in mortality after myocardial infarction in Sweden but that differences in mortality rates following myocardial infarction still remain between the Swedish counties. Unresolved, however, are questions as to what these inter-county differences mean for the individual patient and what role hospital care plays in this context. We analysed all patients aged 64-85 years who were hospitalised following diagnosis of myocardial infarction in Sweden during the period 1993-1996. To gain an understanding of the relevance of geographical differences in mortality after myocardial infarction for the individual patient we applied multi-level regression analysis and calculated county and hospital median odds ratios (MORs) in relation to 28-day mortality. For hospitalised patients with myocardial infarction, being cared for in another hospital with higher mortality would increase the risk of dying by 9% (MOR=1.09) in men and 12% in women. If these patients moved to another county with higher mortality the risk would increase by 7% and 3%, respectively. The small geographical differences in 28-day mortality after myocardial infarction found in Sweden suggest a high degree of equality across the country; however, further improvement could be achieved in hospital care, especially for women - an issue that deserves further analysis.},
  author       = {Merlo, Juan and Håkansson, Anders and Beckman, Anders and Lindblad, Ulf and Lindström, Martin and Gerdtham, Ulf and Råstam, Lennart},
  issn         = {0023-7205},
  keyword      = {Odds Ratio,Myocardial Infarction: therapy,Myocardial Infarction: mortality,Middle Aged,Male,Humans,Hospital Mortality,Female,English Abstract,Aged,Comparative Study,Regression Analysis,Sweden: epidemiology,Quality of Health Care},
  language     = {swe},
  number       = {1-2},
  pages        = {3--20},
  series       = {Läkartidningen},
  title        = {God vård på lika villkor vid hjärtinfarkt i dagens Sverige. Geografiska skillnader i dödlighet utan betyd [Equally good care of myocardial infarction in Sweden today. Geographic differences in mortality are without significance for the individual patient]},
  volume       = {102},
  year         = {2005},
}