Do the poor cost more? A multihospital study of patients' socioeconomic status and use of hospital resources

The New England Journal of Medicine
A M EpsteinJ Weissman

Abstract

There is controversy about whether hospitalized poor patients use more resources and whether hospitals that provide care for the poor therefore merit supplementary payment under per-case prospective payment systems. We previously reported that patients of low socioeconomic status with connective-tissue disease had longer hospital stays and higher costs than patients of higher socioeconomic status at a single hospital. To examine the generalizability of this phenomenon, we interviewed 16,908 (83 percent) of 20,278 consecutive adult patients (excluding obstetrical and psychiatric patients) admitted in 1987 to five Massachusetts hospitals, to obtain information on three direct measures of socioeconomic status (income, occupation, and education). We divided each measure into three strata. Thus, there were 15 comparisons--three measures of socioeconomic status applied to each of five hospitals. After excluding outliers and adjusting for diagnosis-related group (DRG), we found that the patients of the lowest socioeconomic status had hospital stays 3 to 30 percent longer than those of patients of higher status, the differences varying with the hospital and the indicator of socioeconomic status (P less than or equal to 0.05 for 11 of t...Continue Reading

References

Jun 1, 1975·Medical Care·J S Gonnella, M J Goran
Jun 23, 1989·JAMA : the Journal of the American Medical Association·J Weissman, A M Epstein
Jan 9, 1987·JAMA : the Journal of the American Medical Association·S F Jencks, T Kay

❮ Previous
Next ❯

Citations

Jan 1, 1992·Journal of General Internal Medicine·I S UdvarhelyiT H Lee
Jan 18, 2006·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Magali PirsonPol Leclercq
Nov 19, 2011·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Engin Yilmaz, Denis Raynaud
May 7, 1996·Journal of Health Economics·S Martin, P Smith
May 1, 1995·Social Science & Medicine·E GuadagnoliB J McNeil
Jun 12, 1998·Journal of Psychosomatic Research·J B van der Meer, J P Mackenbach
Mar 8, 1997·Journal of Health Economics·G F Kominski, S H Long
Feb 1, 1997·Journal of Clinical Epidemiology·M D MurrayW M Tierney
Jan 3, 1991·The New England Journal of Medicine
Jun 12, 1998·The New England Journal of Medicine·S A SalitA L Mosso
Jan 16, 2008·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Harish JastiMichael J Fine
Jul 27, 2005·Academic Medicine : Journal of the Association of American Medical Colleges·Adrienne GreenLee Goldman
Feb 11, 1999·Australian and New Zealand Journal of Medicine·C J RoeW R Adam
Apr 28, 2006·Journal of General Internal Medicine·Susan M FrayneKatherine M Skinner
Oct 28, 1999·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·L Cardozo, S Aherns
Jul 1, 1997·Annals of the Rheumatic Diseases·A McEntegartE A Thomson
Aug 25, 1999·Annals of the Rheumatic Diseases·N MaidenE A Thomson
Jan 7, 1999·Journal of Epidemiology and Community Health·C J Manson-Siddle, M B Robinson
Nov 28, 2006·BMC Health Services Research·Margaret J McGregorMichelle B Cox
May 1, 2004·American Journal of Public Health·Allison L DiamantLillian Gelberg
Mar 15, 1991·Cancer·J W Yarbro
Jun 1, 1996·American Journal of Public Health·J S HaasE F Cook
Nov 4, 2015·Allergy·Mohsen SadatsafaviUNKNOWN Economic Burden of Asthma Study Group
Mar 21, 2016·The Journal of Arthroplasty·Anthony A CatanzanoJoseph A Bosco
Jul 16, 2003·The American Journal of the Medical Sciences·Mark P AnstadtDaniel M Musher
Jan 24, 2016·Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco·Mandeep S JassalMichelle N Eakin
Feb 20, 2013·Journal of Health Economics·Richard CooksonPaolo Li Donni
Jun 22, 2012·The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland·D BarlowG Andrews
Sep 17, 2015·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Kimberly J HwaBrendan C Visser
Dec 6, 2001·Gaceta sanitaria·F CotsM Riu
Nov 7, 2015·The Journal of Surgical Research·Tahereh SoleimaniSunil S Tholpady
Jun 19, 2009·Health Policy·Santosh Jatrana, Peter Crampton
May 16, 2009·Revue D'épidémiologie Et De Santé Publique·J HolsteinG Chatellier
Aug 1, 1991·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·T B DodsonL B Kaban
Oct 20, 2015·European Journal of Internal Medicine·Seán CournaneBernard Silke

❮ Previous
Next ❯

Related Concepts

Related Feeds

BioHub - Researcher Network

The Chan-Zuckerberg Biohub aims to support the fundamental research and develop the technologies that will enable physicians to cure, prevent, or manage all diseases in our childrens' lifetimes. The CZ Biohub brings together researchers from UC Berkeley, Stanford, and UCSF. Find the latest research from the CZ Biohub researcher network here.