Causal analysis of socioeconomic influence on cost of care: The emergency general surgery model.
Am J Surg
; 226(4): 492-496, 2023 10.
Article
de En
| MEDLINE
| ID: mdl-37117137
ABSTRACT
BACKGROUND:
This study characterizes the relationship between SES and cost of emergency general surgery (EGS).METHODS:
Utilizing Florida AHCA (2016-2020), patients undergoing the 7 most common EGS were identified. Distressed Community Index (DCI) was linked, which quantifies SES through unemployment, poverty, and other factors. Zipcodes are assigned DCI 0 (no distress) to 100 (severe distress). Linear regression with stepwise elimination was conducted. Top and bottom DCI quintiles were propensity matched for demographics, comorbidities, and procedure.RESULTS:
144,924 admissions were included. Linear regression eliminated 5 of 28 variables, including DCI. Top cost contributors were discharge-43%; comorbidities-14%; age-9%. Distressed patients received less home health and inpatient rehab. Distressed patients utilized 4-/5-star hospitals less and had higher odds of mortality.CONCLUSION:
Discharge, mortality, and hospital characteristics differ significantly between DCI communities. Total cost was similar, and is strongly influenced by discharge status, while DCI had no effect.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Chirurgie générale
/
Hôpitaux
Type d'étude:
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
/
Equity_inequality
Limites:
Humans
Pays/Région comme sujet:
America do norte
Langue:
En
Journal:
Am J Surg
Année:
2023
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique