Living in a socioeconomically disadvantaged neighborhood puts patients at high risk for rehospitalization, according to a study published in Annals of Internal Medicine.
Socioeconomic disadvantage is characterized by low income, limited education, and substandard living conditions in one's neighborhood or social network. These factors may contribute to rehospitalization but are often overlooked when creating individual care plans post discharge. Researchers sought to determine the relationship between neighborhood socioeconomic disadvantage and 30-day rehospitalization rates. They reviewed health records for a random national sample of Medicare patients (n = 255,744) discharged from the hospital with congestive heart failure, pneumonia, or acute myocardial infarction. Medicare data were linked to 2000 census data to determine the area deprivation index, or ADI (a composite measure of neighborhood socioeconomic disadvantage), for each patient's ZIP+4 residence. They found that patients who lived in socioeconomically disadvantaged neighborhoods in the U.S. had higher rehospitalization rates regardless of which hospital provided the initial treatment. Living in a disadvantaged neighborhood predicted rehospitalization as strongly as the presence of chronic disease.
The authors conclude that neighborhood disadvantage should be easy to measure using data routinely collected by the U.S. government and may be useful in targeting patient-and community-based initiatives for lowering rehospitalization rates.
Article: Neighborhood Socioeconomic Disadvantage and 30-Day Rehospitalization: A Retrospective Cohort Study, A.J.H. Kind, S. Jencks, J. Brock, M. Yu, C. Bartels, W. Ehlenbach, C. Greenberg, and M. Smith, Annals of Internal Medicine, doi: 10.7326/M13-2946, published 1 December 2014.