Myocardial Infarction in Singapore: Ethnic Variation in Evidence-Based Therapy and Its Association with Socioeconomic Status, Social Network Size and Perceived Stress Level
| Autor: | Thet Hein, Mark Y. Chan, Mark Richards, Bee Choo Tai, Boon-Lock Chia, Qian-Hui Phua, Germaine Loo, Kian Keong Poh, Chi-Hang Lee |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Gerontology Evidence-based practice medicine.medical_treatment Myocardial Infarction Ethnic group Social class Social support medicine Humans Prospective Studies Prospective cohort study Socioeconomic status Aged Aged 80 and over Singapore Evidence-Based Medicine business.industry Social Support Percutaneous coronary intervention Questionnaire Middle Aged Socioeconomic Factors Female Cardiology and Cardiovascular Medicine business Stress Psychological |
| Zdroj: | Heart, Lung and Circulation. 22:1011-1017 |
| ISSN: | 1443-9506 |
| DOI: | 10.1016/j.hlc.2013.04.119 |
| Popis: | Background 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. Methods In a prospective study, patients admitted with STEMI were recruited for a questionnaire survey. Relevant demographic and clinical data were collected. Results 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. Conclusions 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. |
| Databáze: | OpenAIRE |
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