Poor patients may be at higher risk for death after heart surgery, even in a country with universal health care, a new Swedish study finds.
Researchers examined outcomes for more than 100,000 patients in Sweden who had heart surgery over 14 years. In Sweden, the entire population has access to the same health care plan, and heart surgeries are performed at a small number of medical centers with similar care and performance standards.
The link between low income and increased risk of death remained the same even after the investigators included heart risk factors and other health problems.
The study was published online Oct. 19 in the Journal of the American College of Cardiology.
The connection between low income and higher risk of heart disease is well-established, but most studies are conducted in countries without universal health care, where individual wealth can affect access to health care, the researchers said.
The study authors, led by Dr. Magnus Dalen of Karolinska University Hospital in Stockholm, said their findings show that the link between low income and increased risk of death after heart surgery cannot be explained by wealth disparities alone, and that further research is needed to find ways to help low-income patients.
There were several limitations to the study. It did not include data on lifestyle habits such as smoking, diet, physical activity, job stress, or on medication use and health care. Only an association and not cause-and-effect link was seen between income and risk of death after surgery.
The U.S. National Heart, Lung, and Blood Institute has more about heart surgery.