According to the study, lower-income patients who have a heart attack are more likely to die prematurely than higher-income patients.
The research of Harvard Medical School, the University of Texas Medical Branch, Galveston, ICES (formerly the Institute for Clinical Evaluative Sciences), and other international collaborators has revealed that low-income patients in six different countries have mortality rates that are 10 to 20% higher than their high-income peers.
According to the researchers, the findings suggest that income disparities exist even in countries with universal health care and robust social services.
The paper was a project of the International Health System Research Collaborative, an effort dedicated to understanding the trade-offs inherent in different nations’ approaches to health care delivery. It was published in the journal JAMA.
“A country’s health-care system can influence treatment and outcomes for specific health conditions, such as cardiovascular disease,” said Bruce Landon, professor of health-care policy at HMS.
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“We wanted to see if the poorer outcomes seen in lower-income Americans compared to higher-income Americans were reduced in countries with universal health insurance.” “We discovered that high-income people had higher survival rates and were more likely to receive life-saving treatments than low-income people, regardless of their country of residence or health-care system,” he said.
The researchers studied all adults 66 years or older who were hospitalized with a type of heart attack known as ST-elevation myocardial infarction (STEMI), which is more severe, and non-ST-elevation myocardial infarction (NSTEMI) (NSTEMI).
Between 2013 and 2018, outcomes for STEMI and NSTEMI patients with low incomes were compared to outcomes for patients with high incomes in the United States, Canada (Ontario and Manitoba), England, the Netherlands, Taiwan, and Israel. The study included 289,376 patients admitted to the hospital with STEMI and 843,046 patients admitted with NSTEMI.
The findings revealed:
High-income patients had 1 to 3 percentage points lower 30-day mortality after hospitalization. The greatest difference was observed in Canada (14.9 percent and 17.8 percent for high versus low-income individuals with STEMI).
The differences in one-year mortality were even greater, with Israel having the greatest disparity (16.2 percent and 25.3 percent for high versus low-income individuals with STEMI).
Low-income patients in all countries were less likely to receive necessary and aggressive STEMI treatments like cardiac catheterization and revascularization, and readmission rates to hospitals were higher.
In all countries, the lowest-income group had more females than the highest-income group.
