Imperial College London
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Hilary Watt CStat FHEA MSc MA(Oxon) BA

Faculty of Medicine, School of Public Health

Senior Teaching Fellow in Statistics
 
 
 
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Contact

 

+44 (0)20 7594 7451h.watt Website

 
 
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Location

 

322Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Shather:2018:10.1016/j.amjmed.2018.07.003,
author = {Shather, Z and Laverty, A and Bottle, RA and Watt, H and Majeed, FA and Millett, CJ and Vamos, EP},
doi = {10.1016/j.amjmed.2018.07.003},
journal = {The American Journal of Medicine},
pages = {1340--1348},
title = {Sustained socio-economic inequalities in hospital admissions for cardiovascular events among people with diabetes in England},
url = {http://dx.doi.org/10.1016/j.amjmed.2018.07.003},
volume = {131},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - ObjectiveThis study aimed to determine changes in absolute and relative socio-economic inequalities in hospital admissions for major cardiovascular events and procedures among people with diabetes in England.MethodsWe identified all patients with diagnosed diabetes aged ≥45 years admitted to hospital in England between 2004-2005 and 2014-2015 for acute myocardial infarction, stroke, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). Socio-economic status was measured using Index of Multiple Deprivation. Diabetes-specific admission rates were calculated for each year by deprivation quintile. We assessed temporal changes using negative binomial regression models.ResultsMost admissions for cardiovascular causes occurred among people aged ≥65 years (71%) and men (63.3%), and the number of admissions increased steadily from the least to the most deprived quintile. People with diabetes in the most deprived quintile had 1.94-fold increased risk of acute myocardial infarction (95% CI 1.79-2.10), 1.92-fold risk of stroke (95% CI 1.78-2.07), 1.66-fold risk of CABG (95% CI 1.50-1.74), and 1.76-fold risk of PCI (95% CI 1.64-1.89) compared with the least deprived group. Absolute differences in rates between the least and most deprived quintiles did not significantly change for acute myocardial infarction (P=0.29) and were reduced for stroke, CABG and PCI (by 17.5, 15 and 11.8 per 100,000 people with diabetes, respectively, P≤0.01 for all).ConclusionsSocio-economic inequalities persist in diabetes-related hospital admissions for major cardiovascular events in England. Besides improved risk stratification strategies considering socio-economically defined needs, wide-reaching population-based policy interventions are required to reduce inequalities in diabetes outcomes.
AU  - Shather,Z
AU  - Laverty,A
AU  - Bottle,RA
AU  - Watt,H
AU  - Majeed,FA
AU  - Millett,CJ
AU  - Vamos,EP
DO  - 10.1016/j.amjmed.2018.07.003
EP  - 1348
PY  - 2018///
SN  - 0002-9343
SP  - 1340
TI  - Sustained socio-economic inequalities in hospital admissions for cardiovascular events among people with diabetes in England
T2  - The American Journal of Medicine
UR  - http://dx.doi.org/10.1016/j.amjmed.2018.07.003
UR  - https://www.sciencedirect.com/science/article/pii/S0002934318306478?via%3Dihub
UR  - http://hdl.handle.net/10044/1/62070
VL  - 131
ER  -
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