Key result
Living in a highly disadvantaged neighborhood (high Area Deprivation Index) was significantly associated with 30-day readmissions in 15 of 23 included studies (65%).
Why the study?
Recent studies have used the area deprivation index to examine the relationship between neighborhood deprivation and health outcomes, but its overall effect on 30-day readmissions across medical and surgical conditions required determination.
Does high neighborhood socioeconomic disadvantage (measured by ADI) increase the risk of 30-day readmissions in adult patients?
Systematic Review
Does high neighborhood socioeconomic disadvantage (measured by ADI) increase the risk of 30-day readmissions in adult patients?
Living in a highly disadvantaged neighborhood (high ADI) is significantly associated with an increased risk of 30-day readmissions across various medical and surgical conditions.
High ADI was associated with higher 30-day readmissions in most studies; supports incorporating neighborhood disadvantage into risk models while leaving causal effects open.
BACKGROUND: The area deprivation index (ADI) is a measure of neighborhood disadvantage. It uses census-level information to quantify a person's neighborhood deprivation level based on their address. Recent studies have used ADI to examine the relationship between a patient's address and various health outcomes, including 30-day readmissions. OBJECTIVE: This systematic review was conducted to determine the effect of ADI on 30-day readmissions for both medical and surgical conditions. METHODS: We performed a comprehensive literature search in scientific databases, including PubMed, Embase, Web of Science, and SCOPUS from 2013 to 2024. Our search included terms related to ADI and 30-day readmissions in adult populations in the United States. Studies were included if they utilized ADI as their primary exposure and examined the risk of readmissions within 30 days as an outcome. Two reviewers independently extracted the data and assessed quality and biases in the studies. RESULTS: Of the 66 papers found through database search, 23 (35%) were included. These studies focused on conditions such as cardiac, diabetic, neurological, and pulmonary diseases, as well as postsurgical and septic patients, with three studies examining all patients in general. When examining the highest level of ADI, 15 (65%) studies (6 of which focused on postsurgical patients) found that high ADI (most disadvantaged) is significantly associated with 30-day readmissions. CONCLUSION: Living in a high ADI area moderately impacts 30-day readmissions, particularly for patients who have undergone surgery or have undifferentiated problems.
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Muhammad et al. (2024) conducted a systematic review in Medical and surgical conditions. High Area Deprivation Index (ADI) vs. Lower Area Deprivation Index was evaluated on 30-day readmissions. Living in a highly disadvantaged neighborhood (high Area Deprivation Index) was significantly associated with 30-day readmissions in 15 of 23 included studies (65%).
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