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2018-01-26Zeitschriftenartikel DOI: 10.25646/6050
Social Gradients in Myocardial Infarction and Stroke Diagnoses in Emergency Medicine
dc.contributor.authorHanefeld, C.
dc.contributor.authorHaschemi, A.
dc.contributor.authorLampert, Thomas
dc.contributor.authorTrampisch, Hans J.
dc.contributor.authorMügge, Andreas
dc.contributor.authorMiebach, Janine
dc.contributor.authorKloppe, Cordula
dc.contributor.authorKlaaßen-Mielke, Renate
dc.date.accessioned2019-04-09T06:26:23Z
dc.date.available2019-04-09T06:26:23Z
dc.date.issued2018-01-26none
dc.identifier.other10.3238/arztebl.2018.0041
dc.identifier.urihttp://edoc.rki.de/176904/6085
dc.description.abstractBackground: Persons of lower socio-economic status are at higher risk of disease, especially with respect to severe and chronic illnesses. To date, there have not been any studies with large case numbers regarding acute medical emergencies in this population. Methods: In a retrospective study, data were obtained on all cases treated by emergency physicians in Bochum, Germany, in 2014/2015, including the diagnoses that were made by the emergency physicians. There were a total of 16 767 cases. The local unemployment rate was taken as an indicator of the socioeconomic situation of a neighborhood; it was defined as the percentage of registered unemployed persons among persons aged 15 to 64 with their domicile in the neighborhood. 12 168 cases were grouped by emergency medical diagnosis and analyzed with respect to the three most heavily represented diagnostic categories (cardiovascular, neurological, and pulmonary emergencies), which accounted for nearly two-thirds of all diagnoses. Results: The overall rates of deployment involving emergency physicians were found to be positively correlated with the unemployment rate. After adjustment for age, sex, and possible confounders, this correlation was statistically significant (p<0.01). The indirectly standardized rate ratio (IRR) for the overall case-activity rate ranged from 0.841 (95% confidence interval: [0.808; 0.875]) with less than 5% unemployment to 1.212 [1.168; 1.256] with 9.5% unemployment or higher. The same finding was obtained with respect to diagnosis-specific case activity in each of the three main diagnostic categories (cardiovascular, neurological, and pulmonary emergencies), as well as for the respective commonest individual diagnoses (acute coronary syndrome/circulatory arrest [1498 cases], transient ischemic attack/ischemic stroke/intracerebral hemorrhage [1274 cases], and asthma/chronic obstructive pulmonary disease [663 cases]). Conclusion: This study shows that the case-activity rate of the emergency medical services is significantly higher in socially disadvantaged neighborhoods, both with respect to total numbers and with respect to individual diseases. It demonstrates a problem affecting society as a whole, which should be taken into account in the organization of medical rescue services.eng
dc.language.isoengnone
dc.publisherRobert Koch-Institut
dc.subject.ddc610 Medizin und Gesundheitnone
dc.titleSocial Gradients in Myocardial Infarction and Stroke Diagnoses in Emergency Medicinenone
dc.typearticle
dc.subtitleAn Analysis of Socioeconomic Regional Disparities in a German Citynone
dc.identifier.urnurn:nbn:de:kobv:0257-176904/6085-3
dc.identifier.doihttp://dx.doi.org/10.25646/6050
dc.type.versionpublishedVersionnone
local.edoc.container-titleDeutsches Ärzteblattnone
local.edoc.type-nameZeitschriftenartikel
local.edoc.container-typeperiodical
local.edoc.container-type-nameZeitschrift
local.edoc.container-urlhttps://www.aerzteblatt.de/int/archive/article?id=195899none
local.edoc.container-publisher-nameDeutscher Ärzte-Verlagnone
local.edoc.container-volume115none
local.edoc.container-issue4none
local.edoc.container-reportyear2018none
local.edoc.container-year2018none
local.edoc.container-firstpage41none
local.edoc.container-lastpage48none
local.edoc.rki-departmentEpidemiologie und Gesundheitsmonitoringnone
dc.description.versionPeer Reviewednone

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