County-level socioeconomic status data were modestly associated with 30-day mortality (OR 0.97; 95% CI 0.95-1.00; P=0.032) but did not improve risk adjustment models based on patient characteristics.
Observational
Yes
Does adding county-level socioeconomic status to risk-adjustment models improve prediction of 30-day mortality and rehospitalization in Medicare beneficiaries hospitalized with heart failure?
County-level socioeconomic status data do not significantly improve risk adjustment models for 30-day outcomes in heart failure patients beyond standard patient and hospital characteristics.
Effect estimate: OR 0.97 (95% CI 0.95-1.00)
p-value: p=0.032
BACKGROUND: An individual's socioeconomic status (SES) is associated with health outcomes and mortality, yet it is unknown whether accounting for SES can improve risk-adjustment models for 30-day outcomes among Centers for Medicare 95% confidence interval, 0.95-1.00; P=0.032) and the percentage of people with at least a high school diploma (per 5 U increase) was associated with lower odds of 30-day rehospitalization (odds ratio, 0.95; 95% confidence interval, 0.91-0.99). After adjustment for county-level SES data, relative to whites, Hispanic ethnicity (odds ratio, 0.70; 95% confidence interval, 0.58-0.83) and black race (odds ratio, 0.57; 95% confidence interval, 0.50-0.65) remained significantly associated with lower 30-day mortality, but had similar 30-day rehospitalization. County-level SES did not improve risk adjustment or change hospital rankings for 30-day mortality or rehospitalization. CONCLUSIONS: County-level SES data are modestly associated with 30-day outcomes for Centers for Medicare & Medicaid Services beneficiaries hospitalized with heart failure, but do not improve risk adjustment models based on patient characteristics alone.
Eapen et al. (Sat,) conducted a observational in Heart failure. County-level socioeconomic status (SES) data vs. Risk-adjustment models based on patient characteristics alone was evaluated on 30-day all-cause mortality (OR 0.97, 95% CI 0.95-1.00, p=0.032). County-level socioeconomic status data were modestly associated with 30-day mortality (OR 0.97; 95% CI 0.95-1.00; P=0.032) but did not improve risk adjustment models based on patient characteristics.