BMJ  2004;329:172-173 (17 July), doi:10.1136/bmj.329.7458.172-c

Letter

Discharge rates for suspected acute coronary syndromes

Is morbidity or empowerment increasing?

The first 100% of the full text of this article appears below.

EDITOR—In their population based analysis Murphy et al reported a marked increase in morbidity rates for suspected acute coronary syndromes between 1990 and 2000.¹ However, we need to eliminate all reasonable doubt that the trend represents an actual rise and is not simply the result of empowerment of the population, enabled to recognise symptoms and enforce their rights better.

View larger version (39K): [in this window] [in a new window]   Population discharge rates for acute coronary syndromes in people over 75 in Scotland1

 

For example, among "new fashioned" elderly people, this factor may contribute to the reported rise in morbidity which, in the case in point, may not be due solely to the ageing population process. The morbidity rate trends in Scotland by urban and rural areas would be helpful. Traditionally, rates of use are lower in rural areas for partly cultural reasons.^{2 3}

Primary Health Care Unit Health Authority N 17, V G Marconi 19, 35043 Monselice (PD), Italy pghid@libero.it

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Competing interests: None declared.

1. Murphy NF, MacIntyre K, Capewell S, Stewart S, Pell J, Chalmers J, et al. Hospital discharge rates for suspected acute coronary syndromes between 1990 and 2000: population based analysis. BMJ 2004;328: 1413-4. (12 June.)[Free Full Text]
2. Sheikh K, Bullock C. Urban-rural differences in the quality of care for Medicare patients with acute myocardial infarction. Arch Intern Med 2001;161: 737-43.[Abstract/Free Full Text]
3. Mariotto A. Urban-rural differences in the quality of care for Medicare patients with acute myocardial infarction. Arch Intern Med 2001;161: 2386-7.[Free Full Text]

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Relevant Article

Hospital discharge rates for suspected acute coronary syndromes between 1990 and 2000: population based analysis

N F Murphy, K MacIntyre, S Capewell, S Stewart, J Pell, J Chalmers, A Redpath, S Frame, J Boyd, and J J V McMurray
BMJ 2004 328: 1413-1414. [Extract] [Full Text] [PDF]

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