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Equality in the care and treatment of immigrants and native Swedes--a comparative study of patients hospitalised for heart failure

Journal article
Authors Azar Hedemalm
Maria Schaufelberger
Inger Ekman
Published in European Journal of Cardiovascular Nursing
Volume 7
Issue 3
Pages 222-8
ISSN 1474-5151
Publication year 2008
Published at Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
Institute of Health and Care Sciences
Pages 222-8
Language en
Keywords Aged, Cardiovascular Agents, Drug Utilization, *Emigrants and Immigrants, Female, *Health Services Accessibility, Heart Failure/complications/diagnosis/ethnology/*therapy, Humans, Male, Matched-Pair Analysis, *Medical Audit, Patient Discharge, Patient Readmission, *Physician's Practice Patterns, Referral and Consultation, Retrospective Studies, Sweden/epidemiology
Subject categories Cardiac and Cardiovascular Systems


The aim of this study was to compare immigrant and Swedish patients with heart failure (HF) regarding symptoms, diagnosis, medical treatment, discharge planning, readmission and mortality. The method was descriptive and retrospective using an audit protocol to review data from 214 medical records of 107 immigrants and 107 Swedish patients hospitalised for HF or chronic heart failure during 1994-2003. Descriptive statistics and significance testing were performed. Few differences between the patient groups were observed. Significantly larger number of immigrants were referred to the nurse-led HF clinic follow-up visits (P=0.026). Significantly more immigrants had ischemic heart disease on admission (P=0.025) and were prescribed short-acting nitrates at discharge (P=0.026). More Swedes were prescribed medications for insomnia (P=0.029). More immigrants than Swedes are referred to HF clinic after discharge, suggesting that physicians rely on specialised nurses to provide follow-ups, tailored to the needs of immigrant patients. The study indicates that the Swedish health care system has achieved its aim of equality in the care and treatment of this patient group. Further studies are needed to determine if this also applies to the quality of the provided care and treatment.

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