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Acute myocardial infarction: a comparison of the risk between physicians and the general population.

Chen YT, Huang CC, Weng SF, Hsu CC, Wang JJ, Lin HJ, Su SB, Guo HR, Juan CW - Biomed Res Int (2015)

Bottom Line: Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant.Medical center physicians had a lower risk than did local clinic physicians.Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan.

ABSTRACT
Physicians in Taiwan have a heavy workload and a stressful workplace, both of which may contribute to cardiovascular disease. However, the risk of acute myocardial infarction (AMI) in physicians is not clear. This population-based cohort study used Taiwan's National Health Insurance Research Database. We identified 28,062 physicians as the case group and randomly selected 84,186 nonmedical staff patients as the control group. We used a conditional logistic regression to compare the AMI risk between physicians and controls. Subgroup analyses of physician specialty, age, gender, comorbidities, area, and hospital level were also done. Physicians have a higher prevalence of HTN (23.59% versus 19.06%, P < 0.0001) and hyperlipidemia (21.36% versus 12.93%, P < 0.0001) but a lower risk of AMI than did the controls (adjusted odds ratio (AOR): 0.57; 95% confidence interval (CI): 0.46-0.72) after adjusting for DM, HTN, hyperlipidemia, and area. Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant. Medical center physicians had a lower risk (AOR: 0.42; 95% CI: 0.20-0.85) than did local clinic physicians. Taiwan's physicians had higher prevalences of HTN and hyperlipidemia, but a lower risk of AMI than did the general population. Medical center physicians had a lower risk than did local clinic physicians. Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment.

No MeSH data available.


Related in: MedlinePlus

Flow chart for the study. AMI: acute myocardial infarction; LHID: Longitudinal Health Insurance Database.
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Related In: Results  -  Collection


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fig1: Flow chart for the study. AMI: acute myocardial infarction; LHID: Longitudinal Health Insurance Database.

Mentions: Data on the physicians were obtained from the Registry of Medical Personnel (PER), which contained all registered medical staff in 2009. We then excluded physicians who were dual specialists (e.g., a physician board certified in internal medicine and emergency medicine) and physicians who were not specialists (i.e., residents) (Figure 1). We excluded dual specialists because of the difficulty involved with assigning them to a specific subgroup for comparison. We excluded residents because their practice time in individual specialties is short. In the control group, we selected three matches (nonmedical staff) per case from the Longitudinal Health Insurance Database 2000 (LHID2000), which contains all claims data of one million (4.34% of the total population) beneficiaries who were randomly selected in 2000 (Figure 1). There are no significant differences in age, gender, or health care costs between the LHID2000 and all NHI enrollees. Controls were matched with cases by age, birth year, and gender (Figure 1).


Acute myocardial infarction: a comparison of the risk between physicians and the general population.

Chen YT, Huang CC, Weng SF, Hsu CC, Wang JJ, Lin HJ, Su SB, Guo HR, Juan CW - Biomed Res Int (2015)

Flow chart for the study. AMI: acute myocardial infarction; LHID: Longitudinal Health Insurance Database.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4352724&req=5

fig1: Flow chart for the study. AMI: acute myocardial infarction; LHID: Longitudinal Health Insurance Database.
Mentions: Data on the physicians were obtained from the Registry of Medical Personnel (PER), which contained all registered medical staff in 2009. We then excluded physicians who were dual specialists (e.g., a physician board certified in internal medicine and emergency medicine) and physicians who were not specialists (i.e., residents) (Figure 1). We excluded dual specialists because of the difficulty involved with assigning them to a specific subgroup for comparison. We excluded residents because their practice time in individual specialties is short. In the control group, we selected three matches (nonmedical staff) per case from the Longitudinal Health Insurance Database 2000 (LHID2000), which contains all claims data of one million (4.34% of the total population) beneficiaries who were randomly selected in 2000 (Figure 1). There are no significant differences in age, gender, or health care costs between the LHID2000 and all NHI enrollees. Controls were matched with cases by age, birth year, and gender (Figure 1).

Bottom Line: Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant.Medical center physicians had a lower risk than did local clinic physicians.Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan.

ABSTRACT
Physicians in Taiwan have a heavy workload and a stressful workplace, both of which may contribute to cardiovascular disease. However, the risk of acute myocardial infarction (AMI) in physicians is not clear. This population-based cohort study used Taiwan's National Health Insurance Research Database. We identified 28,062 physicians as the case group and randomly selected 84,186 nonmedical staff patients as the control group. We used a conditional logistic regression to compare the AMI risk between physicians and controls. Subgroup analyses of physician specialty, age, gender, comorbidities, area, and hospital level were also done. Physicians have a higher prevalence of HTN (23.59% versus 19.06%, P < 0.0001) and hyperlipidemia (21.36% versus 12.93%, P < 0.0001) but a lower risk of AMI than did the controls (adjusted odds ratio (AOR): 0.57; 95% confidence interval (CI): 0.46-0.72) after adjusting for DM, HTN, hyperlipidemia, and area. Between medical specialty, age, and area subgroups, differences in the risk for having an AMI were nonsignificant. Medical center physicians had a lower risk (AOR: 0.42; 95% CI: 0.20-0.85) than did local clinic physicians. Taiwan's physicians had higher prevalences of HTN and hyperlipidemia, but a lower risk of AMI than did the general population. Medical center physicians had a lower risk than did local clinic physicians. Physicians are not necessary healthier than the general public, but physicians, especially in medical centers, have a greater awareness of disease and greater access to medical care, which permits timely treatment and may prevent critical conditions such as AMI induced by delayed treatment.

No MeSH data available.


Related in: MedlinePlus