Despite Overall Improvement In Surgical Outcomes Since 2000, Income-Related Disparities Persist

Qasim, Mehwish; Andrews, Roxanne M

doi:10.1377/hlthaff.2013.0194

Cited by 14 publications

(15 citation statements)

References 27 publications

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“…However, the two social risk factors used in this article, dual eligibility and race, are generally available and accurately measured in claims data . These two factors capture patient attributes for which there is strong evidence of substantial disparities in health outcomes . Related to this is the potential heterogeneity of effect of social risk factors.…”

Section: Discussionmentioning

confidence: 99%

“…34 These two factors capture patient attributes for which there is strong evidence of substantial disparities in health outcomes. [11][12][13][14][15] Another practical limitation is that we did not account for cooccurrence of social risk factors. Some patients were both dual eligible and African American and, thus, either effect may have reflected in part that of the other risk factor.…”

Section: Limitationsmentioning

confidence: 99%

“…[4][5][6] In this context, and with the goal of promoting health care equity, multiple stakeholders have proposed to highlight disparities in outcome measures by social risk factors. [7][8][9][10] Despite these recommendations and persisting disparities in health outcomes, [11][12][13][14][15] few quality measures or methods have emerged for highlighting health care disparities, and none are in widespread use.…”

Section: Introductionmentioning

confidence: 99%

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Measuring hospital‐specific disparities by dual eligibility and race to reduce health inequities

Lloren

Liu

Herrin

et al. 2019

Health Services Research

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Objective To propose and evaluate a metric for quantifying hospital‐specific disparities in health outcomes that can be used by patients and hospitals. Data Sources/Study Setting Inpatient admissions for Medicare patients with acute myocardial infarction, heart failure, or pneumonia to all non‐federal, short‐term, acute care hospitals during 2012‐2015. Study Design Building on the current Centers for Medicare and Medicaid Services methodology for calculating risk‐standardized readmission rates, we developed models that include a hospital‐specific random coefficient for either patient dual eligibility status or African American race. These coefficients quantify the difference in risk‐standardized outcomes by dual eligibility and race at a given hospital after accounting for the hospital's patient case mix and proportion of dual eligible or African American patients. We demonstrate this approach and report variation and performance in hospital‐specific disparities. Principal Findings Dual eligibility and African American race were associated with higher readmission rates within hospitals for all three conditions. However, this disparity effect varied substantially across hospitals. Conclusion Our models isolate a hospital‐specific disparity effect and demonstrate variation in quality of care for different groups of patients across conditions and hospitals. Illuminating within‐hospital disparities can incentivize hospitals to reduce inequities in health care quality.

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Measuring hospital‐specific disparities by dual eligibility and race to reduce health inequities

Lloren

Liu

Herrin

et al. 2019

Health Services Research

View full text Add to dashboard Cite

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“…The 2 primary contributors to health-care disparities are differences among patients and differences in the medical care that they receive 30 . While we incorporated all relevant patient information that was available to us, detailed analyses of additional characteristics that affect health and health-care utilization, such as social determinants and individual patient preferences, are needed.…”

Section: Discussionmentioning

confidence: 99%

Racial and Socioeconomic Disparities in Hip Fracture Care

Lane

Pan

et al. 2016

The Journal of Bone and Joint Surgery

129

126

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“…18 In patients undergoing major surgery, factors related to or derivative of socioeconomic status have been suggested as influential, not only to cancer presentation but also to outcomes of surgery. 10 This can be significant, encompassing parameters such as Union Internationale Contre le Cancer (UICC) tumor stage, 19 length of hospital stay, 20 number of postoperative complications, 20,21 and overall survival (OS). 20,22,23 The aforementioned associations between socioeconomic status, surgical outcomes, risks factors for HNC, and previous work suggest that a relationship may indeed exist, 23,24 and in turn, there may be a notable health gradient outcome when applied to HNC also.…”

Section: Introductionmentioning

confidence: 99%

Impact of social deprivation on the outcome of major head and neck cancer surgery in England: A national analysis

et al. 2018

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Background Socioeconomic status plays an important role in the incidence and prognosis of many cancers. We examined the relationship between social deprivation and clinical outcomes in patients undergoing major surgery for head and neck cancer. Methods A retrospective population‐based observational study was performed. Patients undergoing head and neck surgical procedures in England between 2002 and 2012 were identified. This totaled 5051 patients in the less socially deprived (LSD) and 7282 in the more socially deprived (MSD) group. Results MSD patients were younger (61 vs 63) and were more likely to present with hypopharyngeal‐laryngeal cancers (41% vs 30%). They had higher burdens of morbidity and more frequently required emergency surgery (odds ratio [OR] 1.74 [95% CI 1.52‐1.99]). Following surgery, MSD patients had higher lengths of inpatient stay (OR 1.72 [95% CI 1.57‐1.88]) and higher proportions of both inpatient (OR 1.47 [95% CI 1.19‐1.82]) and overall mortality (OR 1.34 [95% CI 1.24‐1.45]). Conclusion Increasing socioeconomic deprivation is associated with poor health outcomes in patients with head and neck cancer.

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Despite Overall Improvement In Surgical Outcomes Since 2000, Income-Related Disparities Persist

Cited by 14 publications

References 27 publications

Measuring hospital‐specific disparities by dual eligibility and race to reduce health inequities

Measuring hospital‐specific disparities by dual eligibility and race to reduce health inequities

Racial and Socioeconomic Disparities in Hip Fracture Care

Impact of social deprivation on the outcome of major head and neck cancer surgery in England: A national analysis

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