Socioeconomic and geographic differences in ablation of atrial fibrillation in Norway - a national cohort study

The aim of this study was to analyse whether there are patient related or geographic differences in the use of catheter ablation among atrial fibrillation patients in Norway. National population-based data on individual level of all Norwegians aged 25 to 75 diagnosed with atrial fibrillation from 20...

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Published in:	BMC public health 2022-02, Vol.22 (1), p.303-303, Article 303
Main Authors:	Olsen, Frank, Uleberg, Bård, Jacobsen, Bjarne K, Heuch, Ivar, Tande, Pål M, Bugge, Einar, Balteskard, Lise
Format:	Article
Language:	eng
Subjects:	Ablation Age Atrial fibrillation Atrial Fibrillation - diagnosis Atrial Fibrillation - epidemiology Atrial Fibrillation - surgery Cardiac arrhythmia Care and treatment Catheter Ablation Catheters Cohort Studies Education Emigration Fibrillation Gender Geographical variations Hospitals Humans Income Medical care Medical instruments Norway Norway - epidemiology Patients Small-area analysis Socioeconomic factors Socioeconomics Statistical analysis Survival analysis Treatment Outcome Universal health care Utilization
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Summary:	The aim of this study was to analyse whether there are patient related or geographic differences in the use of catheter ablation among atrial fibrillation patients in Norway. National population-based data on individual level of all Norwegians aged 25 to 75 diagnosed with atrial fibrillation from 2008 to 2017 were used to study the proportion treated with catheter ablation. Survival analysis, by Cox regression with attained age as time scale, separately by gender, was applied to examine the associations between ablation probability and educational level, income level, place of residence, and follow-up time. Substantial socioeconomic and geographic variation was documented. Atrial fibrillation patients with high level of education and high income were more frequently treated with ablation, and the education effect increased with increasing age. Patients living in the referral area of St. Olavs Hospital Trust had around three times as high ablation rates as patients living in the referral area of Finnmark Hospital Trust. Differences in health literacy, patient preference and demands are probably important causes of socioeconomic variation, and studies on how socioeconomic status influences the choice of treatment are warranted. Some of the geographic variation may reflect differences in ablation capacity. However, geographic variation related to differences in clinical practice and provider preferences implies a need for clearer guidelines, both at the specialist level and at the referring level.
ISSN:	1471-2458 1471-2458