Influence of neighborhood household income on early death or urgent hospital readmission. Issue 5 (10th April 2013)

• Record Type: Journal Article
• Authors: van, Carl; Wong, Jenna; Forster, Alan J.
• Is Part Of: Journal of hospital medicine. Volume 8:Issue 5(2013)
• Page Start: 261
• Page End: 266
• Publication Date: 2013-04-10
• Subjects: Hospital care -- Periodicals; Clinical medicine -- Periodicals; 610
• DOI: 10.1002/jhm.2025
• Languages: English
• ISSNs: 1553-5592

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="jhm2025-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The relationship of socioeconomic status (SES) with hospital readmissions is unclear.</p> </sec> <sec id="jhm2025-sec-0002" sec-type="section"> <title>METHODS</title> <p>We used population‐based administrative datasets to randomly select 40, 827 adult Ontarians discharged from hospital to the community. Patient postal codes were linked to average neighborhood household‐income quintiles. The association of this SES measure with 30‐day death or urgent readmission was measured after controlling for outcome risk using a validated index, LACE+: length of stay (L), acuity of the admission (A), comorbidity of the patient (measured with the Charlson Comorbidity Index score (C), and emergency‐department use (E).</p> </sec> <sec id="jhm2025-sec-0003" sec-type="section"> <title>RESULTS</title> <p>Within 1 month of discharge, 2638 (6.5%) people died or were urgently readmitted. Lower neighborhood income was significantly associated with both an increased outcome risk (<italic>P</italic> < 0.0001) and LACE+ score. After adjusting for LACE+ score, neighborhood income was no longer associated with 30‐day death or urgent readmission (<italic>P</italic> = 0.21).</p> </sec> <sec id="jhm2025-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>After accounting for known risk factors, early death or readmission is not more common in people from lower‐income neighborhoods. Further study is required to determine if SES is associated with adverse postdischarge outcomes in settings without publicly funded healthcare. <italic>Journal of Hospital Medicine</italic> 2013;8:261–266. © 2013 Society of Hospital Medicine</p> </sec> </abstract>