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Editorial
To access or not to access: could that be the question?
  1. Dominique Vervoort1,2
    1. 1 Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada
    2. 2 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
    1. Correspondence to Mr Dominique Vervoort, Division of Cardiac Surgery, University of Toronto, Toronto, ON M5T 3M6, Canada; vervoortdominique{at}hotmail.com

    https://doi.org/10.1136/heartjnl-2024-324647

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      Approximately 1.5 million people undergo cardiac surgery every year around the world.1 In high-income countries, where the cardiac surgical capacity is largely sufficient, the ability to undergo and benefit from cardiac surgery in time is influenced by a range of factors, importantly including patients’ social determinants of health, which are “the conditions in which people are born, grow, work, live and age, and the wider set of forces and systems shaping the conditions of daily life.”2 Lai et al 3 evaluate access to cardiac surgery in England between 2010 and 2019, finding that female sex, Black ethnicity and socioeconomic deprivation were associated with poorer utilisation of cardiac surgery and higher mortality within 1 year after surgery.

      Access to cardiac surgery in England

      The authors are to be applauded for their novel work, which provides a first glimpse into variations in cardiac surgical volumes and mid-term outcomes across England. Using comprehensive data from the Hospital Episode Statistics and UK Office for National Statistics, the authors were able to study all relevant admissions within the National Health Service. The authors also used a more granular metric for deprivation with the area-level Index of Multiple Deprivation, which is a weighted measure reflecting area-level income, employment, education, health, crime, housing and living environments, thereby accounting for factors beyond only income. The study was methodologically robust and provides benchmark findings for future research.

      Several limitations and questions do, however, remain. The authors defined access to care strictly as healthcare utilisation, being the rate of …

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      Footnotes

      • X @DVervoort94

      • Contributors DV: conceptualization, writing, review, approval.

      • Funding DV is supported by the Canadian Institutes of Health Research (CIHR) Vanier Canada Graduate Scholarship.

      • Competing interests None declared.

      • Provenance and peer review Commissioned; internally peer reviewed.

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