News: Inpatient mortality rates linked to neighborhood and hospital quality, study shows

In a recent study published in JAMA Network Open, 30-day postoperative mortality rates of Medicare beneficiaries were found to be associated with the patient’s neighborhood characteristics and hospital quality. Researchers noted a significant difference between patients from the most-deprived neighborhoods at low-quality hospitals, who had an 8.1% probability of postoperative mortality, and those from the least-deprived neighborhoods at high-quality hospitals, who had a much lower 3.9% probability.

The study used claims data from the Medicare Provider Analysis and Review files for nonfederal acute care hospitals from 2014 to 2018, JustCoding reported. Researchers analyzed 1,898,829 Medicare beneficiaries who underwent one of five common inpatient surgical procedures:

• Colon resection
• Coronary artery bypass
• Cholecystectomy
• Appendectomy
• Incisional hernia repair

Neighborhood characteristics were determined by the Area Deprivation Index, which uses factors such as education, employment, housing quality, and poverty to rank a neighborhood from most to least advantaged. CMS’ Overall Hospital Quality Star Rating program was used to establish the quality of hospitals for the study.

Other findings showed the postoperative mortality rates among high-quality hospitals was 4.3% while the rates among low-quality hospitals was 7.2%, and likewise least-deprived neighborhoods had a 4.5% rate while the most-deprived had a 6.8% rate.

“These findings suggest that characteristics of a patient’s neighborhood and the hospital where they received treatment were both associated with risk of death after commonly performed inpatient surgical procedures,” the researchers said. “Efforts and investments to address variation in postoperative mortality should include both hospital quality improvement as well as addressing drivers of neighborhood deprivation.”

Editor’s note: To read JustCoding’s coverage of this story, click here. To access the JAMA Network Open study, click here.