PMID- 25912995 OWN - NLM STAT- MEDLINE DCOM- 20160630 LR - 20221207 IS - 1444-2892 (Electronic) IS - 1443-9506 (Linking) VI - 24 IP - 10 DP - 2015 Oct TI - Ethnic differences in coronary artery revascularisation in New Zealand: does the inverse care law still apply? PG - 969-74 LID - S1443-9506(15)00159-6 [pii] LID - 10.1016/j.hlc.2015.03.013 [doi] AB - BACKGROUND: In 2002 striking differences in cardiac revascularisation rates were reported between New Zealand Maori, Pacific and European ethnicities. This paper examines whether this inequity still exists, taking into account ethnic differences in need. METHODS: Age-standardised time trends in intervention rates for coronary artery bypass grafts (CABG), percutaneous coronary intervention (PCI) and ST elevation myocardial infarction (STEMI) were calculated by ethnicity. Ethnic-specific trends were also calculated in the ratio of observed to expected CABG and PCI interventions based on the rate of hospitalisation with a diagnosis of STEMI. RESULTS: On a per capita basis, standardised CABG intervention rates were significantly higher for Pacific (both sexes) and female Maori than Other throughout 2000-2012, and were significantly higher for Maori males than Other in 2009-12. Population based PCI rates were significantly lower for male Maori from 2000-2012, while for female Maori they were significantly lower in 2000-2004 but significantly higher in 2009-12. However, and despite some improvement since 2000-2004, Maori and Pacific intervention numbers for PCI in 2009-2012 were still 22%-32% lower than expected for the rate of STEMI hospitalisation they experience. Overall revascularisation ratios were significantly lower than expected for Maori (both sexes) and Pacific females. CONCLUSIONS: Large increases in the PCI population intervention rates in Maori and Pacific over the period 2000-2012 have not been sufficient to eliminate inequalities in relation to need, except perhaps for Pacific men. CI - Copyright (c) 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. FAU - Sandiford, Peter AU - Sandiford P AD - Department of Planning Funding and Outcomes, Waitemata District Health Board, Auckland, New Zealand. Electronic address: peter.sandiford@waitematadhb.govt.nz. FAU - Bramley, Dale M AU - Bramley DM AD - Chief Executive, Waitemata District Health Board, Auckland, New Zealand. FAU - El-Jack, Seifeddin S AU - El-Jack SS AD - Department of Cardiology, Waitemata District Health Board, Auckland, New Zealand. FAU - Scott, Anthony G AU - Scott AG AD - Department of Cardiology, Waitemata District Health Board, Auckland, New Zealand. LA - eng PT - Journal Article DEP - 20150330 PL - Australia TA - Heart Lung Circ JT - Heart, lung & circulation JID - 100963739 SB - IM MH - Coronary Artery Bypass/*statistics & numerical data/trends MH - Female MH - Healthcare Disparities/*ethnology/trends MH - Humans MH - Male MH - Myocardial Infarction/ethnology/*surgery MH - Native Hawaiian or Other Pacific Islander/*statistics & numerical data MH - New Zealand/epidemiology MH - Percutaneous Coronary Intervention/*statistics & numerical data/trends MH - Sex Factors MH - White People/*statistics & numerical data OTO - NOTNLM OT - Coronary Artery Bypass Grafting OT - Ethnic groups OT - Inequalities OT - Myocardial revascularisation OT - Maori OT - Pacific OT - Percutaneous Coronary Intervention EDAT- 2015/04/29 06:00 MHDA- 2016/07/01 06:00 CRDT- 2015/04/28 06:00 PHST- 2014/03/28 00:00 [received] PHST- 2015/03/02 00:00 [revised] PHST- 2015/03/18 00:00 [accepted] PHST- 2015/04/28 06:00 [entrez] PHST- 2015/04/29 06:00 [pubmed] PHST- 2016/07/01 06:00 [medline] AID - S1443-9506(15)00159-6 [pii] AID - 10.1016/j.hlc.2015.03.013 [doi] PST - ppublish SO - Heart Lung Circ. 2015 Oct;24(10):969-74. doi: 10.1016/j.hlc.2015.03.013. Epub 2015 Mar 30.