Key result
Increased age, comorbidity burden, emergency admission, and male sex were significantly associated with increased all-cause post-procedure mortality up to 90 days (P<0.001).
Why the study?
The ability to predict and prevent suboptimal post-procedural outcomes based on patient demographics at admission may improve health equity, prompting this evaluation of demographic predictors of disparities in mortality, readmission, and discharge.
Do patient demographic characteristics predict disparities in mortality, readmission, and discharge outcomes after procedural hospital admissions?
Cohort (n=40,882)
Yes
Do patient demographic characteristics predict disparities in mortality, readmission, and discharge outcomes after procedural hospital admissions?
Patient demographic factors such as age, sex, comorbidity burden, and emergency admission status are significant predictors of mortality, readmission, and discharge outcomes after procedural admissions.
Should not yet change practice; leaves open whether targeting these admission factors can close post-procedure equity gaps.
BACKGROUND: Although modern Australian healthcare systems provide patient-centred care, the ability to predict and prevent suboptimal post-procedural outcomes based on patient demographics at admission may improve health equity. This study aimed to identify patient demographic characteristics that might predict disparities in mortality, readmission, and discharge outcomes after either an operative or non-operative procedural hospital admission. METHODS: This retrospective cohort study included all surgical and non-surgical procedural admissions at three of the four major metropolitan public hospitals in South Australia in 2022. Multivariable logistic regression, with backwards selection, evaluated association between patient demographic characteristics and outcomes up to 90 days post-procedurally. RESULTS: 40 882 admissions were included. Increased likelihood of all-cause, post-procedure mortality in-hospital, at 30 days, and 90 days, were significantly associated with increased age (P < 0.001), increased comorbidity burden (P < 0.001), an emergency admission (P < 0.001), and male sex (P = 0.046, P = 0.03, P < 0.001, respectively). Identification as ATSI (P < 0.001) and being born in Australia (P = 0.03, P = 0.001, respectively) were associated with an increased likelihood of 30-day hospital readmission and decreased likelihood of discharge directly home, as was increased comorbidity burden (P < 0.001) and emergency admission (P < 0.001). Being married (P < 0.001) and male sex (P = 0.003) were predictive of an increased likelihood of discharging directly home; in contrast to increased age (P < 0.001) which was predictive of decreased likelihood of this occurring. CONCLUSIONS: This study characterized several associations between patient demographic factors present on admission and outcomes after surgical and non-surgical procedures, that can be integrated within patient flow pathways through the Australian healthcare system to improve healthcare equity.
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Kovoor et al. (2024) conducted a cohort in Surgical and non-surgical procedural admissions (n=40,882). Patient demographic characteristics was evaluated on Mortality, readmission, and discharge outcomes up to 90 days post-procedurally (p=<0.001). Increased age, comorbidity burden, emergency admission, and male sex were significantly associated with increased all-cause post-procedure mortality up to 90 days (P<0.001).
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