Inequalities in access to and outcomes of cardiac surgery in England: retrospective analysis of Hospital Episode Statistics (2010-2019)

Florence Y Lai, Ben Gibbison, Alicia O'Cathain, Enoch Akowuah, John G Cleland, Gianni D Angelini, Christina King, Gavin J Murphy, Maria Pufulete*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)

Abstract

BACKGROUND: We aimed to characterise the variation in access to and outcomes of cardiac surgery for people in England.

METHODS: We included people >18 years of age with hospital admission for ischaemic heart disease (IHD) and heart valve disease (HVD) between 2010 and 2019. Within these populations, we identified people who had coronary artery bypass graft (CABG) and/or valve surgery, respectively. We fitted logistic regression models to examine the effects of age, sex, ethnicity and socioeconomic deprivation on having access to surgery and in-hospital mortality, 1-year mortality and hospital readmission.

RESULTS: We included 292 140 people, of whom 28% were women, 11% were from an ethnic minority and 17% were from the most deprived areas. Across all types of surgery, one in five people are readmitted to hospital within 1 year, rising to almost one in four for valve surgery. Women, black people and people living in the most deprived areas were less likely to have access to surgery (CABG: 59%, 32% and 35% less likely; valve: 31%, 33% and 39% less likely, respectively) and more likely to die within 1 year of surgery (CABG: 24%, 85% and 18% more likely, respectively; valve: 19% (women) and 10% (people from most deprived areas) more likely).

CONCLUSIONS: Female sex, black ethnicity and economic deprivation are independently associated with limited access to cardiac surgery and higher post-surgery mortality. Actions are required to address these inequalities.

Original languageEnglish
Article numberheartjnl-2024-324292
Pages (from-to)1262-1269
Number of pages8
JournalHeart (British Cardiac Society)
Volume110
Issue number21
Early online date3 Sept 2024
DOIs
Publication statusE-pub ahead of print - 3 Sept 2024

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2024.

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