Disparities in Outcomes and Resource Use After Hospitalization for Cardiac Surgery by Neighborhood Income

Pediatrics
Brett R AndersonSherry A Glied

Abstract

Significant disparities exist between patients of different races and with different family incomes; less is understood regarding community-level factors on outcomes. In this study, we used linked data from the Pediatric Health Information System database and the US Census Bureau to examine associations between median annual household income by zip code and mortality, length of stay, inpatient standardized costs, and costs per day, over and above the effects of race and payer, first for children undergoing cardiac surgery (2005-2015) and then for all pediatric discharges (2012-2015). Median community-level income was examined as continuous and categorical (by quartile) predictors. Hierarchical logistic and censored linear regression models were constructed. To these models, patient and surgical characteristics, year, race, payer, state, urban or rural designation, and center fixed effects were added. We identified 101 013 cardiac surgical (and 857 833 total) hospitalizations from 46 institutions. Children from the lowest-income neighborhoods who were undergoing cardiac surgery had 1.18 times the odds of mortality (95% confidence interval [CI]: 1.03 to 1.35), 7% longer lengths of stay (CI: 1% to 14%), and 7% higher standardized ...Continue Reading

Citations

Dec 6, 2019·Hospital Pediatrics·K Casey LionRita Mangione-Smith
Aug 28, 2020·World Journal for Pediatric & Congenital Heart Surgery·Joyce L Woo, Brett R Anderson
Nov 20, 2020·Cardiology in the Young·Saira SiddiquiLindsay Freud
Dec 22, 2020·The Annals of Thoracic Surgery·Dominique VervoortAmy G Fiedler
Feb 17, 2021·Anesthesia and Analgesia·Viviane G Nasr, James A DiNardo
Mar 23, 2021·Journal of Cardiac Surgery·Crystal J RichardsonFrederick Tiesenga
Jul 15, 2020·World Neurosurgery·Gregory GlauserNeil R Malhotra
Apr 2, 2021·British Journal of Neurosurgery·Ali FarooqiNeil R Malhotra
Mar 29, 2021·The Journal of Pediatrics·Nelangi M PintoRichard Nelson
Apr 29, 2021·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Cindy L GrinesMichael N Young
Jun 26, 2021·Surgery·Ryan J PowersKyle J Van Arendonk
Sep 2, 2020·The Journal of Thoracic and Cardiovascular Surgery·Natalie JayaramTara Karamlou
Aug 3, 2020·The Journal of Thoracic and Cardiovascular Surgery·Yuen Lie TjoengTitus Chan
Apr 20, 2021·The Annals of Thoracic Surgery·Tara KaramlouRoosevelt G Bryant
Oct 27, 2021·Current Opinion in Cardiology·Lydia M Nashed, Jennifer O'Neil

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