The following is a summary of “Causal analysis of socioeconomic influence on cost of care: The emergency general surgery model,” published in the October 2023 issue of Surgery by Read, et al.

For a study, researchers sought to investigate the relationship between socioeconomic status (SES) and emergency general surgery (EGS) cost.

Using data from the Florida Agency for Health Care Administration (AHCA) spanning from 2016 to 2020, the study identified patients who underwent the seven most common EGS procedures. The Distressed Community Index (DCI) was employed to gauge SES, considering factors such as unemployment, poverty, and other relevant indicators. The DCI assigns values from 0 (no distress) to 100 (severe distress) to different zip codes. Linear regression analysis with stepwise variable elimination was conducted. Patients from the highest and lowest DCI quintiles were matched based on demographics, comorbidities, and the specific EGS procedure they underwent.

A total of 144,924 admissions were included in the study. The linear regression analysis eliminated five of the 28 variables, including the DCI. The primary contributors to cost were discharge-related factors (43%), comorbidities (14%), and patient age (9%). The study found that distressed patients were less likely to receive home health and inpatient rehabilitation services. They also tended to utilize 4-/5-star hospitals less frequently and had higher odds of mortality.

The research demonstrated significant differences in discharge practices, mortality rates, and hospital characteristics between communities with varying DCI scores. While the study found that the total cost of EGS was similar across different SES groups, the cost was heavily influenced by factors related to the discharge process, whereas the DCI had no significant impact.

Source: americanjournalofsurgery.com/article/S0002-9610(23)00152-6/fulltext