Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study
Background and Aims: To study the associations of neighborhood socioeconomic disadvantage with 30-day mortality and readmission for common gastrointestinal conditions, adjusting for individual demographics, comorbidities, access to health-care resources, and treatment facility characteristics. Metho...
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Elsevier
2025-01-01
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| Series: | Gastro Hep Advances |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572325000019 |
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| author | Beau Blass Jay B. Lusk Hannah Mahoney Molly N. Hoffman Amy G. Clark Jonathan Bae Matthew J. Townsend Amit Patel Andrew J. Muir Bradley G. Hammill |
| author_facet | Beau Blass Jay B. Lusk Hannah Mahoney Molly N. Hoffman Amy G. Clark Jonathan Bae Matthew J. Townsend Amit Patel Andrew J. Muir Bradley G. Hammill |
| author_sort | Beau Blass |
| collection | DOAJ |
| description | Background and Aims: To study the associations of neighborhood socioeconomic disadvantage with 30-day mortality and readmission for common gastrointestinal conditions, adjusting for individual demographics, comorbidities, access to health-care resources, and treatment facility characteristics. Methods: We analyzed a nationwide sample of United States Medicare beneficiaries hospitalized from 2017 to 2019 for common gastrointestinal diseases, grouped by diagnosis-related groups. We then estimated the association of neighborhood socioeconomic disadvantage, measured by the Area Deprivation Index, with 30-day mortality and readmission utilizing logistic regression models with restricted cubic splines. We performed multistep adjustments for individual socioeconomic status and demographics, medical comorbidities, access to inpatient and outpatient health-care resources, and hospital-level characteristics. Results: In total, 1,293,483 patients in the mortality cohort and 1,289,106 patients in the readmission cohort were included in analysis. The fully adjusted model demonstrated an association between neighborhood deprivation and 30-day mortality for patients with common gastrointestinal diseases, with the strongest associations for nonmalignant pancreatic disorders (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.25–2.01), esophageal disorders (OR 1.50, 95% 1.02–2.21), gastrointestinal hemorrhage (OR 1.40, 95% CI 1.29–1.52), and biliary tract disorders (OR 1.40, 95% CI 1.16–1.69) in the most deprived groups. Neighborhood deprivation was not associated with 30-day readmission after full adjustment. Conclusion: We describe an independent association between neighborhood deprivation and 30-day mortality for patients with common gastrointestinal diseases, which remains even after controlling for individual poverty, demographics and comorbidities, access to health-care resources, and characteristics of treating facilities. |
| format | Article |
| id | doaj-art-3fdc5fe8b6b54b44b60a92629ee36f2d |
| institution | OA Journals |
| issn | 2772-5723 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj-art-3fdc5fe8b6b54b44b60a92629ee36f2d2025-08-20T02:16:29ZengElsevierGastro Hep Advances2772-57232025-01-014510061410.1016/j.gastha.2025.100614Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide StudyBeau Blass0Jay B. Lusk1Hannah Mahoney2Molly N. Hoffman3Amy G. Clark4Jonathan Bae5Matthew J. Townsend6Amit Patel7Andrew J. Muir8Bradley G. Hammill9Duke University School of Medicine, Durham, North CarolinaDepartment of Medicine, Duke University School of Medicine, Durham, North CarolinaDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North CarolinaDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North CarolinaDepartment of Population Health Sciences, Duke University School of Medicine, Durham, North CarolinaDepartment of Medicine, Duke University School of Medicine, Durham, North CarolinaDepartment of Medicine, Duke University School of Medicine, Durham, North CarolinaDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Durham Veterans Affairs Medical Center, Durham, North CarolinaDepartment of Medicine, Duke University School of Medicine, Durham, North CarolinaDepartment of Medicine, Duke University School of Medicine, Durham, North Carolina; Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina; Correspondence: Address correspondence to: Bradley G. Hammill, DrPH, Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina 27701.Background and Aims: To study the associations of neighborhood socioeconomic disadvantage with 30-day mortality and readmission for common gastrointestinal conditions, adjusting for individual demographics, comorbidities, access to health-care resources, and treatment facility characteristics. Methods: We analyzed a nationwide sample of United States Medicare beneficiaries hospitalized from 2017 to 2019 for common gastrointestinal diseases, grouped by diagnosis-related groups. We then estimated the association of neighborhood socioeconomic disadvantage, measured by the Area Deprivation Index, with 30-day mortality and readmission utilizing logistic regression models with restricted cubic splines. We performed multistep adjustments for individual socioeconomic status and demographics, medical comorbidities, access to inpatient and outpatient health-care resources, and hospital-level characteristics. Results: In total, 1,293,483 patients in the mortality cohort and 1,289,106 patients in the readmission cohort were included in analysis. The fully adjusted model demonstrated an association between neighborhood deprivation and 30-day mortality for patients with common gastrointestinal diseases, with the strongest associations for nonmalignant pancreatic disorders (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.25–2.01), esophageal disorders (OR 1.50, 95% 1.02–2.21), gastrointestinal hemorrhage (OR 1.40, 95% CI 1.29–1.52), and biliary tract disorders (OR 1.40, 95% CI 1.16–1.69) in the most deprived groups. Neighborhood deprivation was not associated with 30-day readmission after full adjustment. Conclusion: We describe an independent association between neighborhood deprivation and 30-day mortality for patients with common gastrointestinal diseases, which remains even after controlling for individual poverty, demographics and comorbidities, access to health-care resources, and characteristics of treating facilities.http://www.sciencedirect.com/science/article/pii/S2772572325000019Neighborhood DeprivationGastrointestinal DiseaseHealth DisparitiesArea Deprivation IndexEquitySocioeconomic |
| spellingShingle | Beau Blass Jay B. Lusk Hannah Mahoney Molly N. Hoffman Amy G. Clark Jonathan Bae Matthew J. Townsend Amit Patel Andrew J. Muir Bradley G. Hammill Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study Gastro Hep Advances Neighborhood Deprivation Gastrointestinal Disease Health Disparities Area Deprivation Index Equity Socioeconomic |
| title | Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study |
| title_full | Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study |
| title_fullStr | Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study |
| title_full_unstemmed | Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study |
| title_short | Neighborhood Socioeconomic Deprivation and 30-Day Outcomes After Admission for Common Gastrointestinal Conditions: A Large Nationwide Study |
| title_sort | neighborhood socioeconomic deprivation and 30 day outcomes after admission for common gastrointestinal conditions a large nationwide study |
| topic | Neighborhood Deprivation Gastrointestinal Disease Health Disparities Area Deprivation Index Equity Socioeconomic |
| url | http://www.sciencedirect.com/science/article/pii/S2772572325000019 |
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