Senior Citizens Living in Poorest ZIP Codes Less
Likely to Survive Surgery
All surgery patients in the wealthiest ZIP codes
proved less likely to die
By Amy Sutton, Contributing Writer Health Behavior News Service
Sept.
16, 2008 - Elderly patients living in impoverished areas are more likely
to die after undergoing surgery compared to peers from higher-income ZIP
codes, a new study finds.
While some prior studies have documented
socioeconomic disparities in the outcomes of individual procedures, ours
is the first to show that the relationship is consistent across a wide
range of surgical procedures, said lead study author Nancy Birkmeyer,
Ph.D.
Birkmeyer, an associate professor of surgery at the
University of Michigan, and colleagues used census and Medicare data to
evaluate postoperative death rates in more than 1 million elderly
patients. All patients had undergone one of six common, high-risk
surgical procedures between 1999 and 2003.
The study appears in the September issue of the
journal Medical Care.
For all of the surgical procedures - heart or
cancer surgery - socioeconomic status significantly influenced the
patients risk of death. Odds of dying were between 17 percent and 39
percent higher for patients with low socioeconomic status, the authors
found.
Patients that live in socioeconomically
disadvantaged areas have higher surgical mortality rates compared to
patients that live in areas with higher socioeconomic status. This is
mainly because the quality of care is lower at hospitals where patients
of lower socioeconomic status tend to be treated, Birkmeyer said.
In fact, all patients - regardless of income - who
underwent treatment at the hospitals in the poorest areas were more
likely to die, whereas all patients undergoing surgery in the wealthiest
ZIP codes proved less likely to die.
It may be that hospitals that treat patients of
lower socioeconomic status have lower quality of care due to fewer
resources, such as technologically advanced equipment or specialists,
Birkmeyer said.
Harlan Krumholz, M.D., A professor of medicine,
epidemiology and public health at Yale University, called the study a
first step in understanding the patterns of care, but said that the
findings do not provide concrete answers for elderly patients needing
surgery.
The study can only really raise questions about
inequalities in outcomes, because the authors have limitations in their
ability to know the socioeconomic status of any particular patient and
the condition of the patient when they had the surgery, Krumholz said.
Nevertheless, it is time for us to look closely at whether people are
getting the same care and outcomes regardless of their financial
circumstances.
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Sept.
16, 2008 - Elderly patients living in impoverished areas are more likely
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codes, a new study finds.
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