Bierman Arlene S, Brown Adalsteinn D, Levinton Carey M
University of Toronto, 155 College Street, 3rd floor, Toronto, Ontario, M5T 3M7, Canada.
University of Toronto, 155 College Street 4th floor, Toronto, Ontario, M5T 3M7, Canada.
Int J Equity Health. 2015 Dec 23;14:155. doi: 10.1186/s12939-015-0280-x.
Methods to measure or quantify equity in health care remain scarce, if not difficult to interpret. A novel method to measure health equity is presented, applied to gender health equity, and illustrated with an example of timing of angiography in patients following a hospital admission for an acute coronary syndrome.
Linked administrative hospital discharge and survey data was used to identify a retrospective cohort of patients hospitalized with Acute Coronary Syndrome (ACS) between 2002 and 2008 who also responded to the Canadian Community Health Survey (CCHS), was analyzed using decision trees to determine whether gender impacted the delay to angiography following an ACS.
Defining a delay to angiography as 1 day or more, resulted in a non-significant difference in an equity score of 0.14 for women and 0.12 for men, where 0 and 1 represents perfect equity and inequity respectively. Using 2 and 3 day delays as a secondary outcome resulted in women and men producing scores of 0.19 and 0.17 for a 2 day delay and 0.22 and 0.23 for a 3 day delay.
A technique developed expressly for measuring equity suggests that men and women in Ontario receive equitable care in access to angiography with respect to timeliness following an ACS.
衡量或量化医疗保健公平性的方法仍然稀缺，即便并非难以解读。本文介绍了一种衡量健康公平性的新方法，将其应用于性别健康公平性，并以急性冠状动脉综合征住院患者血管造影的时机为例进行说明。
利用医院出院行政数据与调查数据相链接，确定了2002年至2008年间因急性冠状动脉综合征（ACS）住院且回复了加拿大社区健康调查（CCHS）的患者回顾性队列，使用决策树进行分析，以确定性别是否会影响ACS后血管造影的延迟。
将血管造影延迟定义为1天或更长时间，女性的公平性得分0.14与男性的0.12之间无显著差异，其中0和1分别代表完全公平和不公平。将2天和3天延迟作为次要结果，女性和男性在2天延迟时的得分分别为0.19和0.17，在3天延迟时的得分分别为0.22和0.23。
专门开发的一种衡量公平性的技术表明，安大略省的男性和女性在ACS后血管造影的及时性方面获得了公平的医疗服务。
