Dickman R L, Bukowski S
J Fam Pract. 1982 Feb;14(2):233-9.
Despite an extensive literature on coronary artery bypass grafting (CABG) surgery in the last decade, relatively little has been written on the demographic or socioeconomic characteristics of patients who receive this limited medical resource. In the present study data were collected on all patients (N = 539) who received this procedure over a one-year period (July 1977 to June 1978) within Erie County in western New York. Using available census tract data, age-sex adjusted surgery rates by socioeconomic status are developed for defined geographic areas. Patients residing in the city of Buffalo and those from census tracts in the lowest quartile of median family income have dramatically lower surgery rates than do others in the county (P less than .001). Although these discrepancies in CABG surgery rates may be partially explained by differing incidence rates of the medical indications for CABG surgery, problems of access to the service may be operative. Three different principles of distributive justice (equality, liberty, and utility) are discussed in an attempt to see how they might be applicable to the pattern documented.
尽管在过去十年间有大量关于冠状动脉旁路移植术（CABG）的文献，但对于接受这种有限医疗资源的患者的人口统计学或社会经济特征的描述却相对较少。在本研究中，收集了纽约州西部伊利县在一年期间（1977年7月至1978年6月）接受该手术的所有患者（N = 539）的数据。利用现有的普查区数据，针对特定地理区域制定了按社会经济地位进行年龄 - 性别调整后的手术率。居住在布法罗市的患者以及来自家庭收入中位数处于最低四分位数的普查区的患者，其手术率显著低于该县的其他患者（P <.001）。虽然CABG手术率的这些差异可能部分归因于CABG手术医学指征的不同发病率，但获取该服务的问题可能也在起作用。本文讨论了三种不同的分配正义原则（平等、自由和效用），试图探讨它们如何适用于所记录的模式。
