BACKGROUND: The relationship of socioeconomic status (SES) with hospital readmissions is unclear. METHODS: We used population-based administrative datasets to randomly select 40,827 adult Ontarians discharged from hospital to the community. Patient postal codes were linked to average neighborhood household-income quintiles. The association of this SES measure with 30-day death or urgent readmission was measured after controlling for outcome risk using a validated index, LACE+: length of stay (L), acuity of the admission (A), comorbidity of the patient (measured with the Charlson Comorbidity Index score (C), and emergency-department use (E). RESULTS: Within 1 month of discharge, 2638 (6.5%) people died or were urgently readmitted. Lower neighborhood income was significantly associated with both an increased outcome risk (P < 0.0001) and LACE+ score. After adjusting for LACE+ score, neighborhood income was no longer associated with 30-day death or urgent readmission (P = 0.21). CONCLUSIONS: After accounting for known risk factors, early death or readmission is not more common in people from lower-income neighborhoods. Further study is required to determine if SES is associated with adverse postdischarge outcomes in settings without publicly funded healthcare.
RCT Entities:
BACKGROUND: The relationship of socioeconomic status (SES) with hospital readmissions is unclear. METHODS: We used population-based administrative datasets to randomly select 40,827 adult Ontarians discharged from hospital to the community. Patient postal codes were linked to average neighborhood household-income quintiles. The association of this SES measure with 30-day death or urgent readmission was measured after controlling for outcome risk using a validated index, LACE+: length of stay (L), acuity of the admission (A), comorbidity of the patient (measured with the Charlson Comorbidity Index score (C), and emergency-department use (E). RESULTS: Within 1 month of discharge, 2638 (6.5%) people died or were urgently readmitted. Lower neighborhood income was significantly associated with both an increased outcome risk (P < 0.0001) and LACE+ score. After adjusting for LACE+ score, neighborhood income was no longer associated with 30-day death or urgent readmission (P = 0.21). CONCLUSIONS: After accounting for known risk factors, early death or readmission is not more common in people from lower-income neighborhoods. Further study is required to determine if SES is associated with adverse postdischarge outcomes in settings without publicly funded healthcare.
Authors: Amy J H Kind; Steve Jencks; Jane Brock; Menggang Yu; Christie Bartels; William Ehlenbach; Caprice Greenberg; Maureen Smith Journal: Ann Intern Med Date: 2014-12-02 Impact factor: 25.391
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Authors: Robert W Smith; Kerry Kuluski; Andrew P Costa; Samir K Sinha; Richard H Glazier; Alan Forster; Lianne Jeffs Journal: BMJ Open Date: 2017-12-12 Impact factor: 2.692
Authors: Milda R Saunders; Ana C Ricardo; Jinsong Chen; Amanda H Anderson; Esteban A Cedillo-Couvert; Michael J Fischer; Jesus Hernandez-Rivera; Margaret T Hicken; Jesse Y Hsu; Xiaoming Zhang; Denise Hynes; Bernard Jaar; John W Kusek; Panduranga Rao; Harold I Feldman; Alan S Go; James P Lash Journal: Medicine (Baltimore) Date: 2020-07-10 Impact factor: 1.817