期刊
AMERICAN JOURNAL OF MEDICAL QUALITY
卷 33, 期 5, 页码 493-501出版社
SAGE PUBLICATIONS INC
DOI: 10.1177/1062860617753063
关键词
hospital readmission; quality of care; socioeconomic status; Area Deprivation Index; neighborhood characteristics
资金
- National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIH) [R01MD010243]
A growing body of evidence has shown that neighborhood characteristics have significant effects on quality metrics that evaluate health plans or health care providers. Using a data set of an urban teaching hospital patient discharges, this study aimed to determine whether a significant effect of neighborhood characteristics, measured by the Area Deprivation Index, could be observed on patients' readmission risk, independent of patient-level clinical and demographic factors. This study found that patients residing in more disadvantaged neighborhoods had significantly higher 30-day readmission risks compared to those living in less disadvantaged neighborhoods, even after accounting for individual-level factors. Those who lived in the most extremely socioeconomically challenged neighborhoods were 70% more likely to be readmitted than their counterparts who lived in less disadvantaged neighborhoods. These findings suggest that neighborhood-level factors should be considered along with individual-level factors in future work on adjustment of quality metrics for social risk factors.
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