Impact of socio-economic status on hospital length of stay following injury: a multicenter cohort study View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-07-25

AUTHORS

Lynne Moore, Brahim Cisse, Brice Lionel Batomen Kuimi, Henry T. Stelfox, Alexis F. Turgeon, François Lauzier, Julien Clément, Gilles Bourgeois

ABSTRACT

BACKGROUND: Injury is second only to cardiovascular disease in terms of acute care costs in North America. One key to improving injury care efficiency is to generate knowledge on the determinants of resource use. Socio-economic status (SES) is a documented risk factor for injury severity and mortality but its impact on length of stay (LOS) for injury admissions is unknown. This study aimed to examine the relationship between SES and LOS following injury. This multicenter retrospective cohort study was based on adults discharged alive from any trauma center (2007-2012; 57 hospitals; 65,486 patients) in a Canadian integrated provincial trauma system. SES was determined using ecological indices of material and social deprivation. Mean differences in LOS adjusted for age, gender, comorbidities, and injury severity were generated using multivariate linear regression. RESULTS: Mean LOS was 13.5 days. Patients in the highest quintile of material/social deprivation had a mean LOS 0.5 days (95 % CI 0.1-0.9)/1.4 days (1.1-1.8) longer than those in the lowest quintile. Patients in the highest quintiles of both social and material deprivation had a mean LOS 2.6 days (1.8-3.5) longer than those in the lowest quintiles. CONCLUSIONS: Results suggest that patients admitted for traumatic injury who suffer from high social and/or material deprivation have longer acute care LOS in a universal-access health care system. The reasons behind observed differences need to be further explored but may indicate that discharge planning should take patient SES into consideration. More... »

PAGES

285

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12913-015-0949-2

DOI

http://dx.doi.org/10.1186/s12913-015-0949-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1013303551

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26204932


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33 schema:description BACKGROUND: Injury is second only to cardiovascular disease in terms of acute care costs in North America. One key to improving injury care efficiency is to generate knowledge on the determinants of resource use. Socio-economic status (SES) is a documented risk factor for injury severity and mortality but its impact on length of stay (LOS) for injury admissions is unknown. This study aimed to examine the relationship between SES and LOS following injury. This multicenter retrospective cohort study was based on adults discharged alive from any trauma center (2007-2012; 57 hospitals; 65,486 patients) in a Canadian integrated provincial trauma system. SES was determined using ecological indices of material and social deprivation. Mean differences in LOS adjusted for age, gender, comorbidities, and injury severity were generated using multivariate linear regression. RESULTS: Mean LOS was 13.5 days. Patients in the highest quintile of material/social deprivation had a mean LOS 0.5 days (95 % CI 0.1-0.9)/1.4 days (1.1-1.8) longer than those in the lowest quintile. Patients in the highest quintiles of both social and material deprivation had a mean LOS 2.6 days (1.8-3.5) longer than those in the lowest quintiles. CONCLUSIONS: Results suggest that patients admitted for traumatic injury who suffer from high social and/or material deprivation have longer acute care LOS in a universal-access health care system. The reasons behind observed differences need to be further explored but may indicate that discharge planning should take patient SES into consideration.
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42 LOS 0.5 days
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44 North America
45 acute care LOS
46 acute care costs
47 admission
48 adults
49 age
50 cardiovascular disease
51 care LOS
52 care costs
53 care efficiency
54 care system
55 center
56 cohort study
57 comorbidities
58 consideration
59 cost
60 days
61 deprivation
62 determinants
63 differences
64 discharge planning
65 disease
66 ecological indices
67 efficiency
68 factors
69 gender
70 health care system
71 highest quintile
72 hospital length
73 impact
74 index
75 injury
76 injury admissions
77 injury care efficiency
78 injury severity
79 key
80 knowledge
81 length
82 length of stay
83 linear regression
84 longer acute care LOS
85 lowest quintile
86 material deprivation
87 material/social deprivation
88 materials
89 mean LOS
90 mean LOS 0.5 days
91 mean LOS 2.6 days
92 mortality
93 multicenter cohort study
94 multicenter retrospective cohort study
95 multivariate linear regression
96 observed differences
97 patient s
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99 planning
100 provincial trauma system
101 quintile
102 reasons
103 regression
104 relationship
105 resource use
106 results
107 retrospective cohort study
108 risk factors
109 severity
110 social deprivation
111 socio-economic status
112 status
113 stay
114 study
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117 trauma center
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