Cardiac Department, National University Heart Centre, Singapore.
Heart Lung Circ. 2013 Dec;22(12):1011-7. doi: 10.1016/j.hlc.2013.04.119. Epub 2013 May 28.
Singapore is a multiethnic Asian country comprising predominantly Chinese, Malays, and Indians. We sought to study the disparities in evidence-based therapy for people from these three ethnic groups who were admitted to hospital with ST-segment elevation myocardial infarction (STEMI). We also examined its association with socioeconomic level and social network size and the influence on psychological stress level.
In a prospective study, patients admitted with STEMI were recruited for a questionnaire survey. Relevant demographic and clinical data were collected.
A total of 364 patients were recruited and categorised based on ethnicity: Chinese (222 patients), Malays (72 patients), and Indians (70 patients). Malays and Indians were significantly younger than Chinese at the time of presentation with STEMI. Malays had significantly more children than the Chinese and Indians. Malays were in the lowest socioeconomic class, based on education level (P ≤ .02) and residential type (P ≤ .003). Most (87%) patients were treated with primary percutaneous coronary intervention. There were no significant differences between Chinese, Malays, and Indians in accessibility to primary percutaneous coronary intervention, symptom-to-balloon time, door-to-balloon time, and prescription of evidence-based medications. Malays had larger social networks for information support (P ≤ .05) and financial support (P ≤ .04) than Chinese and Indians. There were no significant differences between the three ethnic groups in satisfaction with social support. The perceived stress level was higher among Malays and Indians than Chinese.
Although Malays were underprivileged in the socioeconomic level, no significant difference in healthcare disparities were observed among the three ethnic groups. This may be a reflection of the advancement in Singapore's healthcare system. The lower socioeconomic level may also explain the higher perceived stress level in Malays.
新加坡是一个多民族的亚洲国家，主要由华人、马来人和印度人组成。我们旨在研究因 ST 段抬高型心肌梗死（STEMI）住院的这三个民族人群在接受循证治疗方面的差异。我们还探讨了这些差异与社会经济地位和社会网络规模的关系，以及对心理压力水平的影响。
在一项前瞻性研究中，我们招募了因 STEMI 入院的患者进行问卷调查。收集了相关的人口统计学和临床数据。
共招募了 364 名患者，并根据种族进行分类：华人（222 名患者）、马来人（72 名患者）和印度人（70 名患者）。马来人和印度人在 STEMI 发作时比华人明显更年轻。马来人的孩子数量明显多于华人。马来人处于最低社会经济阶层，依据教育程度（P≤0.02）和居住类型（P≤0.003）。大多数（87%）患者接受了直接经皮冠状动脉介入治疗。在接受直接经皮冠状动脉介入治疗的可及性、症状至球囊时间、进门至球囊时间以及开具循证药物方面，华人、马来人和印度人之间没有显著差异。马来人在信息支持（P≤0.05）和财务支持（P≤0.04）方面的社会网络规模较大。在对社会支持的满意度方面，三个种族之间没有显著差异。马来人和印度人的感知压力水平高于华人。
尽管马来人在社会经济地位方面处于不利地位，但在这三个民族群体中，我们并未观察到医疗保健方面的显著差异。这可能反映了新加坡医疗保健系统的进步。较低的社会经济地位也可能解释了马来人感知到的更高压力水平。
