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[Equally good care of myocardial infarction in Sweden today. Geographic differences in mortality are without significance for the individual patient]
Lakartidningen. 2005 Jan 3-16;102(1-2):20-3
Publication Type
Juan Merlo
Anders Håkansson
Anders Beckman
Ulf Lindblad
Martin Lindström
Ulf-G Gerdtham
Lennart Råstam
Author Affiliation
Samhällsmedicinska institutionen, Universitetssjukhuset MAS, Malmö.
Lakartidningen. 2005 Jan 3-16;102(1-2):20-3
Publication Type
Comparative Study
English Abstract
Hospital Mortality
Middle Aged
Myocardial Infarction - mortality - therapy
Odds Ratio
Quality of Health Care
Regression Analysis
Sweden - epidemiology
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 = l.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.
Comment In: Lakartidningen. 2005 Jan 3-16;102(1-2):9-1015707101
PubMed ID
15707102 View in PubMed
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