Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.

<h4>Background</h4>High technology in the field of interventional cardiology applied in tertiary hospitals has brought enormous benefits in the treatment of ischemic heart disease (IHD). However, IHD mortality rates remain high. We analyzed the relationship between IHD mortality rate and...

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Autores principales:	Luciano de Andrade, Vanessa Zanini, Adelia Portero Batilana, Elias Cesar Araujo de Carvalho, Ricardo Pietrobon, Oscar Kenji Nihei, Maria Dalva de Barros Carvalho
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e2ac0133c7084cee915bc97c58291222
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spelling	oai:doaj.org-article:e2ac0133c7084cee915bc97c582912222021-11-18T07:52:51ZRegional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.1932-620310.1371/journal.pone.0059363https://doaj.org/article/e2ac0133c7084cee915bc97c582912222013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23527174/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>High technology in the field of interventional cardiology applied in tertiary hospitals has brought enormous benefits in the treatment of ischemic heart disease (IHD). However, IHD mortality rates remain high. We analyzed the relationship between IHD mortality rate and the socioeconomic, demographic, and geographic conditions in 399 cities in Parana state, Brazil, from 2006 to 2010.<h4>Methods and results</h4>Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics and evaluated through Exploratory Spatial Data Analysis. GeoDa™ was used to analyze 29.351 deaths across 399 cities. We found a positive spatial autocorrelation regarding IHD mortality (I = 0.5913, p = 0.001). There was a significant positive association between each of three socioeconomic and demographic indicators and IHD mortality rate: Population Elderly Index (I = 0.3436), Illiteracy Rate (I = 0.1873) and City Development Index (I = 0.0900). In addition, two indicators presented significant negative association with IHD mortality rate: Adjusted Population Size (I = -0.1216) and Gross Domestic Product (I = -0.0864). We also found a positive association between IHD mortality rates and the geographic distances between patients' city of residence and their corresponding regional referral centers in interventional cardiology (I = 0.3368). Cities located within Regional Health Units with Reference Interventional Cardiology Center presented a significantly lower average specific mortality rate by IHD. The high mortality rate by IHD within the Regional Health Units was not restricted to socioeconomic and demographic variables, but dependent on the distance between each city and their reference interventional cardiology center.<h4>Conclusions</h4>We conclude that geographic factors play a significant role in IHD mortality within cities. These findings have important policy implications regarding the geographic distribution of cardiac health care networks in Latin America and in other emerging countries.Luciano de AndradeVanessa ZaniniAdelia Portero BatilanaElias Cesar Araujo de CarvalhoRicardo PietrobonOscar Kenji NiheiMaria Dalva de Barros CarvalhoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 3, p e59363 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Luciano de Andrade Vanessa Zanini Adelia Portero Batilana Elias Cesar Araujo de Carvalho Ricardo Pietrobon Oscar Kenji Nihei Maria Dalva de Barros Carvalho Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.
description	<h4>Background</h4>High technology in the field of interventional cardiology applied in tertiary hospitals has brought enormous benefits in the treatment of ischemic heart disease (IHD). However, IHD mortality rates remain high. We analyzed the relationship between IHD mortality rate and the socioeconomic, demographic, and geographic conditions in 399 cities in Parana state, Brazil, from 2006 to 2010.<h4>Methods and results</h4>Data were obtained from the Mortality Information System and the Brazilian Institute of Geography and Statistics and evaluated through Exploratory Spatial Data Analysis. GeoDa™ was used to analyze 29.351 deaths across 399 cities. We found a positive spatial autocorrelation regarding IHD mortality (I = 0.5913, p = 0.001). There was a significant positive association between each of three socioeconomic and demographic indicators and IHD mortality rate: Population Elderly Index (I = 0.3436), Illiteracy Rate (I = 0.1873) and City Development Index (I = 0.0900). In addition, two indicators presented significant negative association with IHD mortality rate: Adjusted Population Size (I = -0.1216) and Gross Domestic Product (I = -0.0864). We also found a positive association between IHD mortality rates and the geographic distances between patients' city of residence and their corresponding regional referral centers in interventional cardiology (I = 0.3368). Cities located within Regional Health Units with Reference Interventional Cardiology Center presented a significantly lower average specific mortality rate by IHD. The high mortality rate by IHD within the Regional Health Units was not restricted to socioeconomic and demographic variables, but dependent on the distance between each city and their reference interventional cardiology center.<h4>Conclusions</h4>We conclude that geographic factors play a significant role in IHD mortality within cities. These findings have important policy implications regarding the geographic distribution of cardiac health care networks in Latin America and in other emerging countries.
format	article
author	Luciano de Andrade Vanessa Zanini Adelia Portero Batilana Elias Cesar Araujo de Carvalho Ricardo Pietrobon Oscar Kenji Nihei Maria Dalva de Barros Carvalho
author_facet	Luciano de Andrade Vanessa Zanini Adelia Portero Batilana Elias Cesar Araujo de Carvalho Ricardo Pietrobon Oscar Kenji Nihei Maria Dalva de Barros Carvalho
author_sort	Luciano de Andrade
title	Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.
title_short	Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.
title_full	Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.
title_fullStr	Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.
title_full_unstemmed	Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.
title_sort	regional disparities in mortality after ischemic heart disease in a brazilian state from 2006 to 2010.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/e2ac0133c7084cee915bc97c58291222
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Regional disparities in mortality after ischemic heart disease in a Brazilian state from 2006 to 2010.

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