ACCESS TO CARDIAC SERVICES

A scoping review of inequalities in access to cardiac services

Background

In March 2000 the National Service Framework for Coronary Heart Disease highlighted how the burden of coronary heart disease (CHD) was inequitably distributed across society with variations in access to some services. This document also set national standards for the care and prevention of coronary heart disease in the UK with the purpose of improving health, reducing inequalities and raising the quality of care with respect to cardiac services. The aim of this review was to briefly outline the scope and quality of the relevant literature relating to inequalities in access to cardiac services and the effectiveness of interventions to reduce such inequalities.

Findings

There appears to be a reasonably large body of UK-based literature investigating inequalities in access to cardiac services from 1995 onwards. Several systematic reviews already exist in this area, though they do not cover all of the cardiac services and therefore, up-to-date systematic reviews are needed to cover the gaps in the evidence identified.

There appeared to be a distinct lack of good quality UK-based primary research investigating the effectiveness of interventions to reduce inequalities in access to cardiac services. Only eight studies were identified in this category and the majority of evidence identified came from uncontrolled observational studies. The priority in the UK should be to increase the number of good quality RCTs and controlled studies investigating the effectiveness of interventions to reduce inequalities in access to cardiac services.

Conducted by: CRD

Publications

Centre for Reviews and Dissemination. Inequalities in access to cardiac services: a scoping review. York: University of York; 2003

Funding

The DH Policy Research Programme (PRP) funded designated review capacity to enable CRD to provide a timely response to PRP requests for reviews. This review was undertaken as part of that funding.