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Inequalities in the use of secondary prevention of cardiovascular disease by socioeconomic status: evidence from the PURE observational study Adrianna Murphy, PhD, Benjamin Palafox, MSc, Prof Owen O'Donnell, PhD, Prof David Stuckler, PhD, Pablo Perel, PhD, Prof Khalid F AlHabib, MBBS, Prof Alvaro Avezum, PhD, Xiulin Bai, BSc, Prof Jephat Chifamba, DPhil, Prof Clara K Chow, PhD, Daniel J Corsi, PhD, Gilles R Dagenais, MD, Antonio L Dans, MD, Rafael Diaz, MD, Ayse N Erbakan, MD, Noorhassim Ismail, MD, Romaina Iqbal, PhD, Roya Kelishadi, MD, Rasha Khatib, PhD, Fernando Lanas, PhD, Prof Scott A Lear, PhD, Prof Wei Li, PhD, Jia Liu, MSc, Prof Patricio Lopez-Jaramillo, PhD, Prof Viswanathan Mohan, MD, Nahed Monsef, PhD, Prem K Mony, MD, Prof Thandi Puoane, DrPH, Sumathy Rangarajan, MSc, Prof Annika Rosengren, MD, Prof Aletta E Schutte, PhD, Mariz Sintaha, MSc, Prof Koon K Teo, PhD, Prof Andreas Wielgosz, MD, Karen Yeates, MD, Lu Yin, PhD, Prof Khalid Yusoff, MBBS, Katarzyna Zatońska, PhD, Prof Salim Yusuf, PhD, Prof Martin McKee, PhD The Lancet Global Health Volume 6, Issue 3, Pages e292-e301 (March 2018) DOI: /S X(18) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0. license Terms and Conditions
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Figure 1 High-low plot showing the 95% confidence range for the use of at least one secondary prevention drug by wealth tertile in the PURE study countries Countries are ordered by 2006 per capita gross domestic product. Countries with significant p values for the hypothesis test that the absolute difference in adjusted prevalence between the richest and poorest tertiles is equal to zero: China, p=0·0259; Colombia, p=0·0002; Bangladesh, p=0·0025; India, p=0·0000; Pakistan, p=0·0006; and Zimbabwe, p=0·0066. The Lancet Global Health 2018 6, e292-e301DOI: ( /S X(18) ) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0. license Terms and Conditions
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Figure 2 Scatter plots of Wagstaff concentration index of inequality in secondary prevention use against national-level and community-level health system factors (A) Use of at least one secondary prevention drug, (B) availability and (C) affordability of medicines, (D) gross national income per capita, (E) public expenditure on health as a proportion of GDP, and (F) out-of-pocket payment as a proportion of total health expenditure. ARG=Argentina. BGD=Bangladesh. BRA=Brazil. CAN=Canada. CHL=Chile. CHN=China. COL=Colombia. IND=India. IRN=Iran. MYS=Malaysia. OPT=occupied Palestinian territory. PAK=Pakistan. PHL=Philippines. POL=Poland. SAU=Saudi Arabia. SWE=Sweden. TUR=Turkey. TZA=Tanzania. UAE=United Arab Emirates. ZAF=South Africa. ZWE=Zimbabwe. GNI=gross national income. GDP=gross domestic product. PPP=purchasing power parity. Int$=international dollar, adjusted for purchasing power parity. The Lancet Global Health 2018 6, e292-e301DOI: ( /S X(18) ) Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0. license Terms and Conditions
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