ISSN: 1885-5857 Impact factor 2023 7.2
Vol. 76. Num. 3.
Pages 213-214 (March 2023)

Letter to the editor
Variability and equity, a debatable relationship

Variabilidad y equidad, una relación discutible

J. Alberto San RománabItziar Gómez Salvadorab
Rev Esp Cardiol. 2022;75:805-1510.1016/j.rec.2022.02.016
José M. de la Torre Hernández, Manuel Lozano González, Tamara García Camarero, David Serrano Lozano, Belén Cid, Soledad Ojeda, Pilar Jiménez Quevedo, Ana Serrador, Bruno García del Blanco, José F. Díaz, Raúl Moreno, Ignacio Cruz-González, Armando Pérez de Prado, Ignacio Fernández Lozano, Óscar Cano Pérez, David Cantarero Prieto
Rev Esp Cardiol. 2023;76:21510.1016/j.rec.2022.11.011
José M. de la Torre-Hernández, Manuel Lozano González, Tamara García Camarero, David Serrano Lozano
Imagen extra
Rev Esp Cardiol. 2023;76:213-4
To the Editor,

In a recent study published in Revista Española de Cardiología, de la Torre Hernández et al.1 conclude that cardiovascular technology use varied considerably across Spain's autonomous communities and that the variability observed could not be explained by economic factors or number of hospital visits. The authors made several references to «equal opportunities» and even mentioned «country-wide deficiencies in equitable access to cardiovascular interventions of proven clinical effectiveness». Based on the study's findings, we believe it may be somewhat rash to draw an inverse correlation between variability in technology use and equitable access to health care interventions. The authors acknowledge certain limitations of their study,1 and these are neatly illustrated in an editorial on the subject.2 Age is one of many factors not assessed in the study that can influence the use of cardiovascular procedures. An autonomous community with an older population, for example, may perform more procedures. Using a simple analysis of data from 2019, we observed a direct regional correlation between mean population age and the number of cardiovascular procedures performed in Spain (figure 1). Variability in clinical practice is certainly an important issue and one that calls for in-depth analysis. Notwithstanding, clinical guidelines leave ample room for case-by-case decision-making. They do not provide recommendations on many clinical situations and should not be followed indiscriminately.

Figure 1.

Correlation between number of cardiovascular procedures studied by Torre Hernández et al.1 and mean population age by autonomous community in 2019. Data obtained from the Spanish Registry of Hemodynamics and Interventional Cardiology3 and the National Statistics Institute, respectively.

(0.5MB).
Funding

None

Authors’ Contributions

Both authors contributed equally.

Conflicts of Interest

None.

References
[1]
J.M. de la Torre Hernández, M. Lozano González, T. García Camarero, et al.
Variabilidad interregional en el uso de tecnologías cardiovasculares (2011-2019). Correlación con índices económicos y frecuentación y mortalidad hospitalarias.
Rev Esp Cardiol., (2022), 75 pp. 806-816
[2]
J. Marrugat, I. Subirana, I.R. Dégano.
¿Hasta qué nivel regional se puede analizar la calidad asistencial?.
Rev Esp Cardiol., (2022), 75
[3]
S. Ojeda, R. Romaguera, I. Cruz-González, R. Moreno.
Registro Español de Hemodinámica y Cardiología Intervencionista. XXIX Informe Oficial de la Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (1990-2019).
Rev Esp Cardiol., (2020), 73 pp. 927-936
Copyright © 2022. Sociedad Española de Cardiología
Are you a healthcare professional authorized to prescribe or dispense medications?