Back to Search
Start Over
Community level socioeconomic status association with surgical outcomes and resource utilisation in a regional cohort: a prospective registry analysis
Community level socioeconomic status association with surgical outcomes and resource utilisation in a regional cohort: a prospective registry analysis
- Source :
- BMJ qualitysafety. 29(3)
- Publication Year :
- 2019
-
Abstract
- BackgroundSocioeconomic status affects surgical outcomes, however these factors are not included in clinical quality improvement data and risk models. We performed a prospective registry analysis to determine if the Distressed Communities Index (DCI), a composite socioeconomic ranking by zip code, could predict risk-adjusted surgical outcomes and resource utilisation.MethodsAll patients undergoing surgery (n=44,451) in a regional quality improvement database (American College of Surgeons-National Surgical Quality Improvement Program ACS-NSQIP) were paired with DCI, ranging from 0–100 (low to high distress) and accounting for unemployment, education level, poverty rate, median income, business growth and housing vacancies. The top quartile of distress was compared to the remainder of the cohort and a mixed effects modeling evaluated ACS-NSQIP risk-adjusted association between DCI and the primary outcomes of surgical complications and resource utilisation.ResultsA total of 9369 (21.1%) patients came from severely distressed communities (DCI >75), who had higher rates of most medical comorbidities as well as transfer status (8.4% vs 4.8%, pConclusionIncreasing Distressed Communities Index is associated with increased postoperative complications and resource utilisation even after ACS-NSQIP risk adjustment. These findings demonstrate a disparity in surgical outcomes based on community level socioeconomic factors, highlighting the continued need for public health innovation and policy initiatives.
- Subjects :
- Adult
Male
medicine.medical_specialty
Quality management
Databases, Factual
Vulnerable Populations
Cohort Studies
03 medical and health sciences
Patient safety
0302 clinical medicine
Postoperative Complications
Residence Characteristics
Risk Factors
medicine
Humans
030212 general & internal medicine
Registries
Socioeconomic status
Poverty
Health policy
Aged
Aged, 80 and over
business.industry
Health Policy
Public health
Middle Aged
Patient Acceptance of Health Care
Quality Improvement
United States
Distress
Quartile
Socioeconomic Factors
030220 oncology & carcinogenesis
Cohort
Female
Risk Adjustment
business
Demography
Subjects
Details
- ISSN :
- 20445423
- Volume :
- 29
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- BMJ qualitysafety
- Accession number :
- edsair.doi.dedup.....690fb115d4d8d46e40a4c7db3d155159