Measuring Socioeconomic Differences in Use of Health Care Services by Wealth Versus by Income

Allin, Sara; Masseria, Cristina; Mossialos, Elías

doi:10.2105/ajph.2008.141499

Cited by 120 publications

(131 citation statements)

References 21 publications

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“…This broad definition of income was used in an attempt to reflect the wealth of each patient, because it has been suggested that wealth is a more sensitive indicator of SES than income. 18 To account for yearly variation in income, we calculated the average income in the 5 years before admission for the patient and cohabiting partner. All patients were divided into tertiles of increasing income.…”

Section: Socioeconomic Statusmentioning

confidence: 99%

Socioeconomic Differences in Quality of Care and Clinical Outcome After Stroke

Langagergaard

Palnum

Mehnert

et al. 2011

Stroke

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Background and Purpose-The association among socioeconomic status, quality of care, and clinical outcome after stroke remains poorly understood. In a Danish nationwide follow-up study, we examined whether socioeconomic-related differences in acute stroke care occur and, if so, whether they explain socioeconomic differences in case-fatality and readmission risk. Methods-Using population-based public registries, we identified and followed all patients aged Յ65 years admitted with stroke from 2003 to 2007 (nϭ14 545). We compared the proportion of patients receiving 7 specific processes of care according to income, educational attainment, and employment status. Furthermore, we computed 30-day and 1-year hazard ratios for death and readmission adjusted for patient characteristics and received processes of acute stroke care. Results-For low-income patients and disability pensioners, the relative risk of receiving all of the relevant processes of care was 0.82 (95% CI, 0.78 to 0.86) and 0.83 (95% CI, 0.79 to 0.87), respectively, compared with high-income patients and employed patients. Adjusted 30-day and 1-year hazard ratios for death for unemployed patients were 1.57 (95% CI, 1.25 to 1.97) and 1.58 (1.32 to 1.88), respectively, compared with employed patients. Unemployed patients also had a higher risk of readmission. The differences in mortality and readmission risk remained after controlling for received processes of acute stroke care. Conclusions-Low socioeconomic status was associated with a lower chance of receiving optimal acute stroke care.However, the differences in acute care did not appear to explain socioeconomic differences in mortality and readmission risk. (Stroke. 2011;42:2896-2902.)

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Section: Socioeconomic Statusmentioning

confidence: 99%

Socioeconomic Differences in Quality of Care and Clinical Outcome After Stroke

Langagergaard

Palnum

Mehnert

et al. 2011

Stroke

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“…This broad definition of income was used in an attempt to reflect the wealth of each patient because it has been suggested that wealth is a more sensitive indicator of SES than income. 12 We calculated the combined average income of each patient and their cohabiting partner in the 5 years before admission. All patients were divided into tertiles of increasing income.…”

Section: Socioeconomic Statusmentioning

confidence: 99%

Dimensions of Socioeconomic Status and Clinical Outcome After Primary Percutaneous Coronary Intervention

Jakobsen

Niemann

Thorsgaard

et al. 2012

Circ: Cardiovascular Interventions

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Background-The association between low socioeconomic status (SES) and high mortality from coronary heart disease is well-known. However, the role of SES in relation to the clinical outcome after primary percutaneous coronary intervention remains poorly understood. Methods and Results-We studied 7385 patients treated with primary percutaneous coronary intervention. Participants were divided into high-SES and low-SES groups according to income, education, and employment status. The primary outcome was major adverse cardiac events (cardiac death, recurrent myocardial infarction, and target vessel revascularization) at maximum follow-up (mean, 3.7 years). Low-SES patients had more adverse baseline risk profiles than high-SES patients. The cumulative risk of major adverse cardiac events after maximum follow-up was higher among low-income patients and unemployed patients compared with their counterparts (income: hazard ratio, 1.68; 95% CI, 1.47-1.92; employment status: hazard ratio, 1.75; 95% CI, 1.46-2.10). After adjustment for patient characteristics, these differences were substantially attenuated (income: hazard ratio, 1.12; 95% CI, 0.93-1.33; employment status: hazard ratio, 1.27; 95% CI, 1.03-1.56). Further adjustment for admission findings, procedure-related data, and medical treatment during followup did not significantly affect the associations. With education as the SES indicator, no between-group differences were observed in the risk of the composite end point. Conclusions-Even in a tax-financed healthcare system, low-SES patients treated with primary percutaneous coronary intervention face a worse prognosis than high-SES patients. The poor outcome seems to be largely explained by differences in baseline patient characteristics. .).The online-only Data Supplement is available at http://circinterventions.ahajournals.org/lookup/suppl

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“…Furthermore, even if income and wealth are positively related, income reflects a flow of resources, which are available over a period, while wealth reflects a stock of resources, which are accumulated over a person's lifetime. Among the elderly, levels of income vary much less than levels of wealth, so wealth allows more accurate measurements of SES differences in health and healthcare utilization in this population (Tsimbos 2010, Allin et al 2009). However, this study showed that wealth played a minor role in affecting the examined cognitive tasks of individuals, while education was a significant protective factor to prevent cognitive decline in aging.…”

Section: Discussionmentioning

confidence: 99%

“…Total assets are the sum value of the primary residence net of mortgage, value of the real estate, owned share of own business, owned cars, and the value of financial assets (bank accounts, government and corporate bonds, stocks, mutual funds, individual retirement accounts, and contractual savings for housing and life insurance policies owned by the household) minus financial liabilities. In this study, wealth instead of income was chosen as an economic indicator for elderly people in line with other literature (Tsimbos 2010, Allin et al 2009). …”

mentioning

confidence: 99%

Social networks and social activities promote cognitive functioning in both concurrent and prospective time: evidence from the SHARE survey

2018

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Measuring Socioeconomic Differences in Use of Health Care Services by Wealth Versus by Income

Abstract: We found some support for wealth as a more sensitive indicator of socioeconomic status among older adults than was income. Wealth may thus allow more accurate measurements of socioeconomic differences in use of health care services for this population.

Cited by 120 publications

References 21 publications

Socioeconomic Differences in Quality of Care and Clinical Outcome After Stroke

Socioeconomic Differences in Quality of Care and Clinical Outcome After Stroke

Dimensions of Socioeconomic Status and Clinical Outcome After Primary Percutaneous Coronary Intervention

Social networks and social activities promote cognitive functioning in both concurrent and prospective time: evidence from the SHARE survey

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