A community-wide perspective of gender differences and temporal trends in the use of diagnostic and revascularization procedures for acute myocardial infarction
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Authors
Chiriboga, David E.Yarzebski, Jorge L.
Goldberg, Robert J.
Chen, Z.
Gurwitz, Jerry H.
Gore, Joel M.
Alpert, Joseph S.
Dalen, James E.
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDepartment of Medicine, Division of Cardiovascular Medicine
Document Type
Journal ArticlePublication Date
1993-02-01Keywords
Age FactorsAged
Chi-Square Distribution
Female
Health Services Accessibility
Heart Function Tests
Hospitals, General
Humans
Incidence
Male
Massachusetts
Middle Aged
Multivariate Analysis
Myocardial Infarction
Myocardial Revascularization
Prejudice
Sex Factors
Time Factors
Cardiology
Cardiovascular Diseases
Metadata
Show full item recordAbstract
This study compares the overall use, as well as temporal trends, of various diagnostic and revascularization procedures for acute myocardial infarction (AMI) in men and women. The study sample comprised a total of 2,924 men and 1,838 women with validated AMI admitted to any of the 16 teaching and community hospitals in the Worcester, Massachusetts, metropolitan area during 1975, 1978, 1981, 1984, 1986 and 1988. During the period under study there was a significant increase in use of each of the examined procedures during hospitalization for AMI in both men and women. Increasing use of multiple procedures was also seen for each of the sexes. After controlling for a variety of demographic and clinical factors that might affect utilization rates, men were marginally more likely to undergo radionuclide ventriculography, and significantly more likely to undergo Holter monitoring, exercise treadmill testing, cardiac catheterization, and percutaneous transluminal coronary angioplasty than women. However, there were no gender differences in the use of coronary artery bypass grafting. On the other hand, men were significantly less likely to undergo echocardiography. The results of this multihospital, population-based study suggest sex differences in the use of several diagnostic and revascularization procedures during hospitalization for AMI. These differences may be attributed to physicians' practice patterns, although gender bias in the delivery of medical care cannot be excluded. Temporal trends in increased overall use of these procedures raise questions about cost-effectiveness that need to be further addressed.Source
Am J Cardiol. 1993 Feb 1;71(4):268-73.
DOI
10.1016/0002-9149(93)90789-fPermanent Link to this Item
http://hdl.handle.net/20.500.14038/47091PubMed ID
8427166Related Resources
ae974a485f413a2113503eed53cd6c53
10.1016/0002-9149(93)90789-f