Social deprivation and hospital admission rates, length of stay and readmissions in emergency medical admissions

Cournane, Seán; Byrne, Declan; Conway, Richard; O’Riordan, Deirdre; Coveney, Seamus; Silke, Bernard

doi:10.1016/j.ejim.2015.09.019

Cited by 27 publications

(35 citation statements)

References 21 publications

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“…For example, although our results agree that AIS and chronic illness predict readmission, 38 the latter still remains an elusive outcome, and a more accurate prediction may be attained by adding socioeconomic variables to models. 39 Our study echoes the potential utility of incorporating common geriatric clinical features in routine clinical examination and disposition planning for older patients in acute settings. 40 Hospitals may find it informative to undertake large-scale screening for geriatric syndromes including frailty, dementia, and delirium in all older adults admitted via the ED.…”

Section: Discussionmentioning

confidence: 52%

The Association of Geriatric Syndromes with Hospital Outcomes

Romero-Ortuño

Forsyth

Wilson

et al. 2017

Journal of Hospital Medicine

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Section: Discussionmentioning

confidence: 52%

The Association of Geriatric Syndromes with Hospital Outcomes

Romero-Ortuño

Forsyth

Wilson

et al. 2017

Journal of Hospital Medicine

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“…Studying data from the Belgian National Health Interview Survey, they find that some health services are more heavily used by patients from deprived backgrounds, but that this effect is mostly explained by these people having poorer health. The relationship between deprivation and emergency admissions is found to vary across the age distribution; 17 deprivation appears to have stronger effects on emergency admissions for younger people in Britain 18 and Ireland, 19 although evidence suggests that in Canada 20 elderly patients with low socioeconomic status were more likely to use the emergency department.…”

Section: Contextmentioning

confidence: 99%

Comparative morbidities and the share of emergencies in hospital admissions in deprived areas: a method and evidence from English administrative data

2018

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ObjectiveVarious studies find that the share of emergencies in hospital admissions is higher in deprived areas, but both the explanation and policy implications are unclear. We estimate the extent to which this finding is due to a different disease mix in deprived areas, rather than other explanations such as patient behaviour and general practitioner effectiveness.DesignSecondary analysis using English Hospital Episode Statistics data, with disease for elective and emergency admissions in 2008/2009 coded at 186 blocks or 1230 categories and aggregated to lower layer super output area of residence. It is then linked to an appropriate measure of deprivation.Outcome measuresThe difference in the share of emergencies in hospital admissions between communities in the highest and lowest deciles of deprivation; and the percentage of this difference that is explained if areas in the least deprived decile have the same disease mix as those in the most deprived decile.ResultsUsing the finest disease classification scheme (1230 categories), 71% of the higher share of admissions that were emergencies in decile 1 areas relative to decile 10, is explained by the “adverse” case mix (CM) in deprived areas. The remainder reflects the higher relative use of emergency care in deprived areas for the same conditions. Higher incidence of respiratory and circulatory diseases in deprived areas explains about 30% of the CM contribution. Diseases of the digestive system and abdomen have a high relative use of emergency care in deprived areas.ConclusionsThe higher use of emergency care in deprived areas is primarily a symptom of the higher prevalence of diseases which have high national rates of emergency to elective care—especially respiratory diseases—rather than an indication of less effective primary care. Nevertheless, there is a higher share of emergency care in admissions in deprived areas for several diseases, most notably of the digestive system.

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“…29 This importantly was for all cause admissions. 29 31 This was seen to dramatically increase for oropharyngeal, oral cavity, and laryngeal cancers, respectively (ASR 3.7 and 3.6, ASR 3.2 and 1.6, and ASR 3.9 and 3). 29 31 This was seen to dramatically increase for oropharyngeal, oral cavity, and laryngeal cancers, respectively (ASR 3.7 and 3.6, ASR 3.2 and 1.6, and ASR 3.9 and 3).…”

Section: Background To the Present Studymentioning

confidence: 95%

“…A previous study of emergency medical admissions (not specifying a surgical population), stratifying along comparable social deprivation quintiles (LSD = 1-3, MSD = 4-5) did not demonstrate any difference on LOS, with an average of 5 days (P < .001) in each group. 29 This importantly was for all cause admissions. 29 Interestingly, readmission was found to be associated with lower socioeconomic quintile, with a 60% greater risk of readmission for the lowest relative to the highest groups.…”

Section: Synopsis Of Key Findingsmentioning

confidence: 95%

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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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Social deprivation and hospital admission rates, length of stay and readmissions in emergency medical admissions

Cited by 27 publications

References 21 publications

The Association of Geriatric Syndromes with Hospital Outcomes

The Association of Geriatric Syndromes with Hospital Outcomes

Comparative morbidities and the share of emergencies in hospital admissions in deprived areas: a method and evidence from English administrative data

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

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