Impact of Socioeconomic Status and Residence Distance on Infant Heart Disease Outcomes in Canada

Figure 1. Population of infants with CHD included in the analyses. AVSD indicates atrioventricular septal defect; CHD, congenital heart disease; and VSD, ventricular septal defect.

Figure 2. Mortality by SES and RoR categories among infants with moderate and severe congenital heart disease. Unadjusted proportions in mortality by SES quintile (top) and RoR category (bottom). For moderate congenital heart disease, SES (P=0.034) and RoR (P=0.044) were associated with mortality, a finding not true for severe congenital heart disease (P=0.092 and P=0.13, respectively). RoR indicates remoteness of residence; and SES, socioeconomic status.

Figure 3. Multivariable analyses of the separate effects of SES and RoR on mortality. References: Quintile 5 for SES and <100 km for RoR category. Mortality was associated with covariates (preterm birth, low birth weight, extracardiac anomalies) in SES and RoR models. Mortality was associated with increasing RoR for moderate CHD (P=0.022) but not for severe CHD (P=0.31) or with SES for either complexity group (moderate CHD, P=0.066; severe CHD, P=0.18). Dotted lines indicate odds ratio and solid lines indicate 95% confidence intervals. CHD indicates congenital heart disease; RoR, remoteness of residence; and SES, socioeconomic status.

Figure 4. Multivariable model of SES quintile and RoR extremes on mortality. References: Quintile 5 for SES and <100 km for RoR category. Mortality was associated with the interaction of distance and income in moderate (P=0.003) but not severe congenital heart disease (P=0.22). Dotted lines indicate odds ratio and solid lines indicate 95% confidence intervals. RoR indicates remoteness of residence; and SES, socioeconomic status.

Figure 5. Impact of SES and RoR on hospital length of stay at first intervention. References: Quintile 5 for SES and <100 km for RoR category. SES quintile (moderate CHD, P<0.0001; severe CHD, P<0.0007) and RoR category (moderate CHD, P=0.0001; severe CHD P=0.047) were associated with differences in length of stay at first intervention after adjusting for mediators. Dotted lines indicate rate ratio and solid lines indicate 95% confidence intervals. CHD indicates congenital heart disease; RoR, remoteness of residence; and SES, socioeconomic status.

Figure 6. Impact of SES and RoR on hospital counts in the first year. References: Quintile 5 for SES and <100 km for RoR category. RoR was associated with fewer hospital counts in the first year (P=0.0004). No other associations reached statistical significance. Dotted lines indicate rate ratio and solid lines indicate 95% confidence intervals. RoR indicates remoteness of residence; and SES, socioeconomic status.