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We thank Dr. Wahler for his comments and his positive comments on our article (1). We agree that in the context of health political planning, analyses of regional socioeconomic disparities make sense in terms of structural adjustments and determining need and that they are necessary. For this reason we explicitly pointed out in our article that the results of the analysis should be considered when organizing emergency medical services.

Dr. Wahler recounts in his letter an incident that he was aware of—which happened in the city of Essen 12 years ago—of an association between the number of patients with myocardial infarctions requiring care and their origin from regions of the city with different socioeconomic profiles. We are not aware of this observation in this form from the local myocardial infarction network, Herzinfarktverbund Essen. In the publications regarding Herzinfarkverbund Essen that we have at our disposal (2, 3), analyses of regional socioeconomic disparities of this type have not been studied. In these articles, the focus is on the results of regionwide implementation of guideline-conform therapy in patients with myocardial infarction. For this reason we cannot comment on the incident reported by Dr. Wahler.

DOI: 10.3238/arztebl.2018.0384b

On behalf of the authors

PD Dr. med. Christoph Hanefeld

Katholisches Klinikum Bochum

St. Elisabeth-Hospital

c.hanefeld@klinikum-bochum.de

Conflict of interest statement

All authors declare that no conflict of interest exists.

1.
Hanefeld C, Haschemi A, Lampert T, et al.: Social gradients in myocardial infarction and stroke diagnoses in emergency medicine—an analysis of socioeconomic regional disparities in a German city. Dtsch Arztebl Int 2018; 115: 41–8. VOLLTEXT
2.
Hailer B, Naber CK, Koslowski B, et al. für den Herzinfarktverbund Essen: Herzinfarktverbund Essen: Ergebnisse nach 1 Jahr. Herz 2008; 33: 153–7 CrossRef MEDLINE
3.
Jacksch R, Naber CK, Koslowski B, für den Herzinfarktverbund Essen: Akutintervention (Primär-PCI) im Rahmen des Essener Herzinfarktverbundes. Herz 2008; 33: 110–4 CrossRef MEDLINE
1.Hanefeld C, Haschemi A, Lampert T, et al.: Social gradients in myocardial infarction and stroke diagnoses in emergency medicine—an analysis of socioeconomic regional disparities in a German city. Dtsch Arztebl Int 2018; 115: 41–8. VOLLTEXT
2.Hailer B, Naber CK, Koslowski B, et al. für den Herzinfarktverbund Essen: Herzinfarktverbund Essen: Ergebnisse nach 1 Jahr. Herz 2008; 33: 153–7 CrossRef MEDLINE
3. Jacksch R, Naber CK, Koslowski B, für den Herzinfarktverbund Essen: Akutintervention (Primär-PCI) im Rahmen des Essener Herzinfarktverbundes. Herz 2008; 33: 110–4 CrossRef MEDLINE

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