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Socioeconomic inequalities in the diffusion of health technology: Uptake of coronary procedures as an example

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  • Korda, Rosemary J.
  • Clements, Mark S.
  • Dixon, Jane

Abstract

This paper examines socioeconomic lags in the diffusion of high technology health care, focusing on the diffusion of coronary procedures in people with ischaemic heart disease. Using linked hospital and mortality data, we studied patients admitted to Western Australian hospitals with a first admission for acute myocardial infarction between 1989 and 2003 (n = 27,209). An outcome event was the receipt, within a year, of a coronary procedure--angiography, angioplasty and/or coronary artery bypass surgery (CABG). Socioeconomic status (SES) was assigned to each individual using the SEIFA Index of Disadvantage. Cox regression was used to model the association between SES and procedure rates in five consecutive three-year time periods. Angiography and CABG showed socioeconomic lags in diffusion, with rates peaking earlier in higher SES patients, such that the inequality patterns were consistent with the inverse equity hypothesis. The evidence for a lag in diffusion for angioplasty was weaker. Overall, that there is some evidence for a lag in diffusion of health technology indicates that it is essential to consider trends over time when examining the equity impact of health technologies.

Suggested Citation

  • Korda, Rosemary J. & Clements, Mark S. & Dixon, Jane, 2011. "Socioeconomic inequalities in the diffusion of health technology: Uptake of coronary procedures as an example," Social Science & Medicine, Elsevier, vol. 72(2), pages 224-229, January.
    • Handle: RePEc:eee:socmed:v:72:y:2011:i:2:p:224-229
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    References listed on IDEAS

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    1. David Cutler & Angus Deaton & Adriana Lleras-Muney, 2006. "The Determinants of Mortality," Journal of Economic Perspectives, American Economic Association, vol. 20(3), pages 97-120, Summer.
    2. Sherry Glied & Adriana Lleras-Muney, 2008. "Technological innovation and inequality in health," Demography, Springer;Population Association of America (PAA), vol. 45(3), pages 741-761, August.
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    Cited by:

    1. Daniel Weiss & Håvard T Rydland & Emil Øversveen & Magnus Rom Jensen & Solvor Solhaug & Steinar Krokstad, 2018. "Innovative technologies and social inequalities in health: A scoping review of the literature," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-20, April.
    2. Vijaya Sundararajan & Ou Yang & Jongsay Yong, 2023. "Socioeconomic status and access to care in a universal healthcare system: The case of acute myocardial infarction in Australia," Melbourne Institute Working Paper Series wp2023n10, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
    3. Rydland, Håvard T., 2020. "Monitoring the social gradient: Inequalities in use of blood pressure monitors in the HUNT study," Technology in Society, Elsevier, vol. 63(C).
    4. Whitty, Jennifer A. & Littlejohns, Peter, 2015. "Social values and health priority setting in Australia: An analysis applied to the context of health technology assessment," Health Policy, Elsevier, vol. 119(2), pages 127-136.
    5. Sundararajan, Vijaya & Yang, Ou & Yong, Jongsay, 2023. "Socioeconomic status and access to care in a universal health care system: The case of acute myocardial infarction in Australia," Journal of Economic Behavior & Organization, Elsevier, vol. 215(C), pages 1-25.
    6. Øyvind Næss & Dominic Hoff, 2013. "The Norwegian Family Based Life Course (NFLC) study: data structure and potential for public health research," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(1), pages 57-64, February.
    7. Terje P. Hagen & Unto Häkkinen & Tor Iversen & Søren Toksvig Klitkou & Tron Anders Moger & on behalf of the EuroHOPE study group, 2015. "Socio‐economic Inequality in the Use of Procedures and Mortality Among AMI Patients: Quantifying the Effects Along Different Paths," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 102-115, December.
    8. Frankovic, Ivan & Kuhn, Michael, 2019. "Access to health care, medical progress and the emergence of the longevity gap: A general equilibrium analysis," The Journal of the Economics of Ageing, Elsevier, vol. 14(C).
    9. Fenton, Anny T. & Elliott, Marc N. & Schwebel, David C. & Berkowitz, Zahava & Liddon, Nicole C. & Tortolero, Susan R. & Cuccaro, Paula M. & Davies, Suzy L. & Schuster, Mark A., 2018. "Unequal interactions: Examining the role of patient-centered care in reducing inequitable diffusion of a medical innovation, the human papillomavirus (HPV) vaccine," Social Science & Medicine, Elsevier, vol. 200(C), pages 238-248.

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