American Heart Journal
Volume 146, Issue 6 , Pages 938-940 , December 2003

Are some patients in canada treated more equally than others? The orwell prophecy

  • David A. Alter, MD, PhD, FRCPC

      Affiliations

    • Institute for Clinical Evaluative Sciences, the Division of Cardiology, Schulich Heart Centre, and the Department of Medicine and Clinical Epidemiology Unit of Sunnybrook and Women's College Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
    • Corresponding Author InformationReprint requests: David A. Alter, MD, PhD, ICES, 2075 Bayview Ave, G Wing-106, Toronto, Ontario, Canada M4N3M5.

Received 7 April 2003 ,Accepted 20 May 2003.

References 

  1. George Orwell {Eric Blair}1903-1950. Animal Farm. 1945; Chapter 10. 2003
  2. Canada Health Act. C-6 (Section 10). 1984
  3. Badgley RF, Wolfe S. Equity and health care, Canadian health care and the state: a century of evolution. Montreal: McGill-Queen's University Press; 1992; p. 193–237
  4. Pilote L. Universal health insurance coverage does not eliminate inequities in access to cardiac procedures after acute myocardial infarction. Am Heart J 2003;146:1030−7
  5. Alter DA, Naylor CD, Austin P, et al.  Effects of socioeconomic status on access to invasive cardiac procedures and on mortality after acute myocardial infarction. N Engl J Med. 1999;341:1359–1367
  6. Alter DA, Basinski AS, Naylor CD. A survey of provider experiences and perceptions of preferential access to cardiovascular care in Ontario, Canada. Ann Intern Med. 1998;129:567–572
  7. McIsaac W, Goel V, Naylor D. Socio-economic status and visits to physicians by adults in Ontario, Canada. J Health Serv Res Policy. 1997;2:94–102
  8. Millar WJ, Stephens T. Social status and health risks in Canadian adults (1985 and 1991). Health Rep. 1993;5:143–156
  9. Enterline PE, Salter V, McDonald AD, et al.  The distribution of medical services before and after “free” medical care (the Quebec experience). N Engl J Med. 1973;289:1174–1178
  10. Organisation for Economic Co-oteration and Development (OECD) Health Data 2002; 4th edition
  11. Naylor CD, Levinton CM, Wheeler S, et al.  Queueing for coronary surgery during severe supply-demand mismatch in a Canadian referral centre (a case study of implicit rationing). Soc Sci Med. 1993;37:61–67
  12. Khaykin Y, Austin PC, Tu JV, et al.  Utilisation of coronary angiography after acute myocardial infarction in Ontario over time (have referral patterns changed?). Heart. 2002;88:460–466
  13. Commission on the future of health hare in Canada. Final Report. November 2002: www.healthcarecommission.ca

☆ Dr Alter is a New Investigator at the Canadian Institutes of Health Research (CIHR), which is funded by both the CIHR and the Heart and Stroke Foundation of Canada. The Institute for Clinical Evaluative Sciences is supported in part by a grant from the Ontario Ministry of Health. The results, conclusions, and opinions are those of the authors, and no endorsement by the Ministry or the Institute is intended or should be inferred.

PII: S0002-8703(03)00449-6

doi: 10.1016/S0002-8703(03)00449-6

American Heart Journal
Volume 146, Issue 6 , Pages 938-940 , December 2003

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