Socioeconomic status and surgical mortality in the elderly

Medical Care
Nancy J O BirkmeyerJohn D Birkmeyer

Abstract

Although racial disparities in the quality of surgical care are well described, the impact of socioeconomic status on operative mortality is relatively unexplored. We used Medicare data to identify all patients undergoing 1 of 6 common, high risk surgical procedures between 1999 and 2003. We constructed a summary measure of socioeconomic status for each US ZIP code using data from the 2000 US Census linked to the patient's ZIP code of residence. We assessed the effects of socioeconomic status on operative mortality rates while controlling for other patient characteristics and then examined the extent to which disparities in operative mortality could be attributed to differences in hospital factors. Socioeconomic status was a significant predictor of operative mortality for all 6 procedures in crude analyses and in those adjusted for patient characteristics. Comparing the lowest quintile of socioeconomic status to the highest, the adjusted odds ratios (OR) and 95% confidence intervals (CI) ranged from OR = 1.17; 95% CI: 1.10-1.25 for colectomy to OR = 1.39; 95% CI: 1.18-1.65 for gastrectomy. After further adjustment for hospital factors, the odds ratio associated with socioeconomic status for coronary artery bypass (OR = 1.14; 9...Continue Reading

References

Jan 1, 1988·Journal of Community Health·D H GemsonP Messeri
Jul 1, 1996·Epidemiology·P D Sorlie, N J Johnson
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Jun 24, 2000·American Journal of Preventive Medicine·A AshfordA I Neugut
Nov 15, 2000·American Journal of Public Health·D B MukamelD L Weimer
Nov 25, 2000·Journal of the American College of Cardiology·C R BridgesL P Coombs
Jul 14, 2001·The New England Journal of Medicine·A V Diez RouxR L Watson
Jul 17, 2001·Annals of Internal Medicine·A R LocalioS E Kimmel
Mar 8, 2002·Journal of Evaluation in Clinical Practice·Adrienne G Randolph, Peter Pronovost
Mar 12, 2002·JAMA : the Journal of the American Medical Association·Eric C SchneiderArnold M Epstein
Apr 26, 2002·The British Journal of Surgery·D J Hole, C S McArdle
Sep 25, 2003·JAMA : the Journal of the American Medical Association·Linda H AikenJeffrey H Silber
Jun 30, 2004·The Annals of Thoracic Surgery·Barbara M RothenbergDana Mukamel
Aug 6, 2004·The New England Journal of Medicine·Peter B BachJ Lee Hargraves
Aug 6, 2004·The New England Journal of Medicine·Arnold M Epstein
Jan 25, 2006·Annals of Surgery·F L LucasJohn D Birkmeyer
Feb 4, 2006·Quality & Safety in Health Care·S P Clarke, L H Aiken
Aug 9, 2006·American Journal of Epidemiology·Avis J ThomasUNKNOWN Multiple Risk Factor Intervention Trial (MRFIT) Research Group
Dec 13, 2006·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Nera AgabitiUNKNOWN Italian Study Group on Inequalities in Health Care

❮ Previous
Next ❯

Citations

Feb 25, 2014·Journal of the American College of Surgeons·Micah E GirottiJustin B Dimick
Aug 27, 2010·Annals of Surgery·Kyla M BennettThomas B Kepler
May 28, 2009·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Tara M BreslinJohn D Birkmeyer
Dec 25, 2012·Annals of Surgical Oncology·Sha'shonda L RevelsSandra L Wong
Dec 14, 2011·The Journal of Bone and Joint Surgery. American Volume·Kevin C ChungJohn D Birkmeyer
Nov 8, 2014·Diseases of the Colon and Rectum·Jeffrey M SuttonIan M Paquette
Jun 8, 2014·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·R Cutler QuillinShimul A Shah
Aug 30, 2008·Medical Care·Peter B Bach
May 3, 2014·Surgery·Charles A MouchArden M Morris
Dec 1, 2012·Journal of the American College of Surgeons·Sha'Shonda L RevelsJohn D Birkmeyer
Jan 9, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Drew J GunnellsDaniel I Chu
Jan 25, 2012·The Surgical Clinics of North America·Heena P Santry, Sherry M Wren
Jul 9, 2010·Journal of the American College of Surgeons·Arden M MorrisJohn D Birkmeyer
Aug 15, 2015·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·K H J UlteeH J M Verhagen
Sep 7, 2013·Journal of the American Geriatrics Society·J Margo Brooks CarthonAnn Kutney-Lee
Apr 14, 2016·The Journal of Arthroplasty·Michele R D'ApuzzoCarlos J Lavernia
Jun 14, 2012·Journal of the American Geriatrics Society·J Margo Brooks CarthonLinda H Aiken
Apr 2, 2011·Cancer·Cathy J BradleyGordon D Ginder
Jul 22, 2014·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Richard S HoehnShimul A Shah
Mar 17, 2015·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Gregory C WilsonShimul A Shah
Apr 5, 2015·Annals of Surgical Oncology·Jeffrey M SuttonDaniel E Abbott
Dec 24, 2014·Liver International : Official Journal of the International Association for the Study of the Liver·Richard S HoehnShimul A Shah
May 17, 2011·Journal of Vascular Surgery·Kerianne H HolmanJohn D Birkmeyer
Aug 26, 2009·Journal of Vascular Surgery·Nicholas H OsborneJustin B Dimick
Apr 30, 2013·The Heart Surgery Forum·Christina M VassilevaStephen Hazelrigg
Nov 29, 2014·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B A MahalP L Nguyen
May 30, 2014·Injury Prevention : Journal of the International Society for Child and Adolescent Injury Prevention·Mary W CarterFrank W Porell
Aug 1, 2016·American Journal of Surgery·Vishnu AmburAmy J Goldberg
Nov 2, 2016·Journal of Neurosurgery. Pediatrics·Mary T AustinDavid I Sandberg
Nov 10, 2016·Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses·Judy N MikhailSamir M Fakhry
Apr 23, 2015·Journal of Oncology Practice·Sandra L Wong

❮ Previous
Next ❯

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