Pediatric Cardiac Surgery Outcomes May Be Affected by Neighborhood Income
Children who were from the lowest-income neighborhoods had worse outcomes in cardiac surgery.
HealthDay News — Children undergoing cardiac surgery from the lowest-income neighborhoods have worse outcomes, according to a study published in Pediatrics.
Brett R. Anderson, MD, from Columbia University Medical Center in New York City, and colleagues examined the correlations between median annual household income by zip code and mortality, length of stay, inpatient standardized costs, and costs per day over and above the effects of race and payer. The correlations were assessed for children undergoing cardiac surgery (2005 to 2015) and for all pediatric discharges from 2012 to 2015. A total of 101,013 cardiac surgical hospitalizations and 857,833 total hospitalizations were identified from 46 institutions.
The researchers found that, compared with children from the highest-income neighborhoods, those from the lowest-income neighborhoods who were undergoing cardiac surgery had increased mortality (odds ratio, 1.18), longer length of stay (7% longer), and higher standardized costs (7% higher). Results were similar for all children, including those with and without any major chronic conditions. Differences in race, payer, or the centers at which patients received care partially explained the effects of neighborhood. No differences were seen in the costs per day.
"Children from lower-income neighborhoods are at increased risk of mortality and use more resource intensive care than children from higher-income communities, even after accounting for disparities between races, payers, and centers," the authors wrote.
Anderson BR, Fieldston ES, Newburger JW, et al. Disparities in outcomes and resource use after hospitalization for cardiac surgery by neighborhood income [published online February 22, 2018]. Pediatrics. doi:10.1542/peds.2017-2432