Geographic and Racial Disparities in Infant Hearing Loss

Lantos, Paul M.; Maradiaga-Panayotti, Gabriela; Barber, Xavier; Raynor, Eileen M.; Tucci, Debara L.; Hoffman, Kate; Permar, Sallie R.; Jackson, Pearce; Hughes, Brenna L.; Kind, Amy; Swamy, Geeta K.

doi:10.1177/0194599818803305

Cited by 49 publications

(39 citation statements)

References 15 publications

(38 reference statements)

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“…(40,54,56,57) The importance of understanding how socioeconomic factors affect the utilization of and access to the healthcare system is becoming increasingly evident. The role of a patient's social and economic circumstances in their overall physical and mental health has been well-elucidated (3,11,31,45,47,52,(57)(58)(59), and our findings are consistent with a limited number of previous studies in documenting an association between socioeconomic status and patient satisfaction scores. caring for patients with, or working in areas with, high levels social deprivation.…”

Section: Resultssupporting

confidence: 90%

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Stephens

Potter

Tyser

et al. 2020

Preprint

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Background Social deprivation has been shown to affect access to health care services, and influences outcomes for a variety of physical and psychological conditions. However, the impact on patient satisfaction remains less clear. The objective of this study was to determine if social deprivation is an independent predictor of patient satisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS). Methods We retrospectively reviewed unique new adult patient (≥18 years of age) seen at a tertiary academic hospital and rural/urban outreach hospitals/clinics between January 2014 and December 2017. Satisfaction was defined a priori as achieving a score above the 33 rd percentile. The 2015 Area Deprivation Index (ADI) was used to determine social deprivation (lower score signifies less social deprivation). Univariate and multivariable binary logistic regression were used to determine the impact of ADI on PGOMPS total and provider sub-scores while controlling for variables previously shown to impact scores (wait time, patient age, sex, race, specialty type, provider type, and insurance status). Results Univariate analysis of PGOMPS total scores revealed a 4% decrease in odds of patient satisfaction per decile increase in ADI (p < 0.001). Patients within the most deprived quartile were significantly less likely to report satisfaction compared to the least deprived quartile (OR 0.79, p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction decreased 2% for each decile increase in ADI on the Total Score (p < 0.001), independent of other variables previously shown to impact scores. For PGOMPS Provider Sub-Score, univariate analysis showed that patients in the lowest ADI quartile were significantly less likely be satisfied, as compared to the least deprived quartile (OR 0.77; 95% CI 0.70 to 0.86; p < 0.001). A 5% decrease in a patient being satisfied was observed for each decile increase in ADI (OR 0.95; 95% CI 0.94 to 0.96; p < 0.001). Conclusions Social deprivation was an independent predictor of outpatient visit dissatisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey. These results necessitate consideration when developing health care delivery policies that serve to minimize inequalities between patients of differing socioeconomic groups.

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Section: Resultssupporting

confidence: 90%

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Stephens

Potter

Tyser

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The importance of understanding how socioeconomic factors affect the utilization of and access to the healthcare system is becoming increasingly evident. The role of a patient's social and economic circumstances in their overall physical and mental health has been well-elucidated(3,11,31,45,47,52,(57)(58)(59), and our findings are consistent with a limited number of previous studies in documenting an association between socioeconomic status and patient satisfaction scores.Young et al demonstrated that average income levels based on zip codes and lower patient satisfaction scores are correlated among elderly patients seen in various specialty clinics (60). McFarland et al evaluated 934,000 patients and showed Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores were directly correlated with education level, which has been used as a surrogate for socioeconomic status in the literature (38).…”

supporting

confidence: 90%

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Stephens

Potter

Tyser

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Social deprivation has been shown to affect access to health care services, and influences outcomes for a variety of physical and psychological conditions. However, the impact on patient satisfaction remains less clear. The objective of this study was to determine if social deprivation is an independent predictor of patient satisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS).Methods We retrospectively reviewed unique new adult patient (≥18 years of age) seen at a tertiary academic hospital and rural/urban outreach hospitals/clinics between January 2014 and December 2017. Satisfaction was defined a priori as achieving a score above the 33rd percentile. The 2015 Area Deprivation Index (ADI) was used to determine social deprivation (lower score signifies less social deprivation). Univariate and multivariable binary logistic regression were used to determine the impact of ADI on PGOMPS total and provider sub-scores while controlling for variables previously shown to impact scores (wait time, patient age, sex, race, specialty type, provider type, and insurance status).Results Univariate analysis of PGOMPS total scores revealed a 4% decrease in odds of patient satisfaction per decile increase in ADI (p < 0.001). Patients within the most deprived quartile were significantly less likely to report satisfaction compared to the least deprived quartile (OR 0.79, p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction decreased 2% for each decile increase in ADI on the Total Score (p < 0.001), independent of other variables previously shown to impact scores. For PGOMPS Provider Sub-Score, univariate analysis showed that patients in the lowest ADI quartile were significantly less likely be satisfied, as compared to the least deprived quartile (OR 0.77; 95% CI 0.70 to 0.86; p < 0.001). A 5% decrease in a patient being satisfied was observed for each decile increase in ADI (OR 0.95; 95% CI 0.94 to 0.96; p < 0.001).Conclusions Social deprivation was an independent predictor of outpatient visit dissatisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey. These results necessitate consideration when developing health care delivery policies that serve to minimize inequalities between patients of differing socioeconomic groups.Registration None

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“…ADI is a composite index that draws from several weighted indicators of neighborhood socioeconomic disadvantage, including constructs of income, employment, education and housing quality [15]. ADI is validated at the neighborhood level and has been used in several other studies [16][17][18].…”

Section: Data Source and Cohort Creationmentioning

confidence: 99%

Neighborhood disadvantage and 30-day readmission risk following Clostridioides difficile infection hospitalization

et al. 2020

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Background Clostridioides difficile infection (CDI) is commonly associated with outcomes like recurrence and readmission. The effect of social determinants of health, such as ‘neighborhood’ socioeconomic disadvantage, on a CDI patient’s health outcomes is unclear. Living in a disadvantaged neighborhood could interfere with a CDI patient’s ability to follow post-discharge care recommendations and the success probability of these recommendations, thereby increasing risk of readmission. We hypothesized that neighborhood disadvantage was associated with 30-day readmission risk in Medicare patients with CDI. Methods In this retrospective cohort study, odds of 30-day readmission for CDI patients are evaluated controlling for patient sociodemographics, comorbidities, and hospital and stay-level variables. The cohort was created from a random 20% national sample of Medicare patients during the first 11 months of 2014. Results From the cohort of 19,490 patients (39% male; 80% white; 83% 65 years or older), 22% were readmitted within 30 days of an index stay. Unadjusted analyses showed that patients from the most disadvantaged neighborhoods were readmitted at a higher rate than those from less disadvantaged neighborhoods (26% vs. 21% rate: unadjusted OR = 1.32 [1.20, 1.45]). This relationship held in adjusted analyses, in which residence in the most disadvantaged neighborhoods was associated with 16% increased odds of readmission (adjusted OR = 1.16 [1.04, 1.28]). Conclusions Residence in disadvantaged neighborhoods poses a significantly increased risk of readmission in CDI patients. Further research should focus on in-depth assessments of this population to better understand the mechanisms underlying these risks and if these findings apply to other infectious diseases.

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Geographic and Racial Disparities in Infant Hearing Loss

Cited by 49 publications

References 15 publications

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Neighborhood disadvantage and 30-day readmission risk following Clostridioides difficile infection hospitalization

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