Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study
Background and Aims: To study the associations of neighborhood socioeconomic disadvantage with 30-day mortality and readmission for common gastrointestinal conditions, adjusting for individual demographics, comorbidities, access to health-care resources, and treatment facility characteristics. Metho...
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| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
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| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572325000019 |
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| Summary: | Background and Aims: To study the associations of neighborhood socioeconomic disadvantage with 30-day mortality and readmission for common gastrointestinal conditions, adjusting for individual demographics, comorbidities, access to health-care resources, and treatment facility characteristics. Methods: We analyzed a nationwide sample of United States Medicare beneficiaries hospitalized from 2017 to 2019 for common gastrointestinal diseases, grouped by diagnosis-related groups. We then estimated the association of neighborhood socioeconomic disadvantage, measured by the Area Deprivation Index, with 30-day mortality and readmission utilizing logistic regression models with restricted cubic splines. We performed multistep adjustments for individual socioeconomic status and demographics, medical comorbidities, access to inpatient and outpatient health-care resources, and hospital-level characteristics. Results: In total, 1,293,483 patients in the mortality cohort and 1,289,106 patients in the readmission cohort were included in analysis. The fully adjusted model demonstrated an association between neighborhood deprivation and 30-day mortality for patients with common gastrointestinal diseases, with the strongest associations for nonmalignant pancreatic disorders (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.25–2.01), esophageal disorders (OR 1.50, 95% 1.02–2.21), gastrointestinal hemorrhage (OR 1.40, 95% CI 1.29–1.52), and biliary tract disorders (OR 1.40, 95% CI 1.16–1.69) in the most deprived groups. Neighborhood deprivation was not associated with 30-day readmission after full adjustment. Conclusion: We describe an independent association between neighborhood deprivation and 30-day mortality for patients with common gastrointestinal diseases, which remains even after controlling for individual poverty, demographics and comorbidities, access to health-care resources, and characteristics of treating facilities. |
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| ISSN: | 2772-5723 |