Using decision trees for measuring gender equity in the timing of angiography in patients with acute coronary syndrome: a novel approach to equity analysis

International Journal for Equity in Health

Research

Adalsteinn D. Brown¹  Arlene S. Bierman²  Carey M. Levinton³ 

[1] University of Toronto, 155 College Street 4th floor, M5T 3M7, Toronto, Ontario, Canada;University of Toronto, 155 College Street, 3rd floor, M5T 3M7, Toronto, Ontario, Canada;University of Toronto, 5 Thomas Elgie Dr. #301, M4G 4J6, Toronto, Ontario, Canada;

关键词: Equity;    Gini coefficient;    Lorenz curve;    Decision trees;   

DOI  :  10.1186/s12939-015-0280-x

 received in 2015-05-27, accepted in 2015-12-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundMethods 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.MethodsLinked 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.ResultsDefining 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.ConclusionsA 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.

【 授权许可】

CC BY   
© Bierman et al. 2015

【 图 表 】

Fig. 2

Fig. 7

Fig. 6