Association of Pediatric Inpatient Socioeconomic Status With Hospital Efficiency and Financial Balance

Michel, Morgane; Alberti, Corinne; Carel, Jean‐Claude; Chevreul, Karine

doi:10.1001/jamanetworkopen.2019.13656

Cited by 20 publications

(14 citation statements)

References 38 publications

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“…The importance of accounting for SES in evaluation of health care quality has also been demonstrated outside of the United States. (79) There are several limitations of this study. The generalization of our ndings to other health care systems with differing regional and patient demographics is limited given that our study was conducted at a single institution treating a population that is predominately white.…”

Section: Discussionmentioning

confidence: 91%

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Stephens

Potter

Tyser

et al. 2020

Preprint

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Background: Social deprivation has been shown to affect access to health care services, and influences outcomes for a variety of physical and psychological conditions. However, the impact on patient satisfaction remains less clear. The objective of this study was to determine if social deprivation is an independent predictor of patient satisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS). Methods: We retrospectively reviewed unique new adult patient (≥18 years of age) seen at a tertiary academic hospital and rural/urban outreach hospitals/clinics between January 2014 and December 2017. Satisfaction was defined a priori as achieving a score above the 33rd percentile. The 2015 Area Deprivation Index (ADI) was used to determine social deprivation (lower score signifies less social deprivation). Univariate and multivariable binary logistic regression were used to determine the impact of ADI on PGOMPS total and provider sub-scores while controlling for variables previously shown to impact scores (wait time, patient age, sex, race, specialty type, provider type, and insurance status).Results: Univariate analysis of PGOMPS total scores revealed a 4% decrease in odds of patient satisfaction per decile increase in ADI (p < 0.001). Patients within the most deprived quartile were significantly less likely to report satisfaction compared to the least deprived quartile (OR 0.79, p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction decreased 2% for each decile increase in ADI on the Total Score (p < 0.001), independent of other variables previously shown to impact scores. For PGOMPS Provider Sub-Score, univariate analysis showed that patients in the lowest ADI quartile were significantly less likely be satisfied, as compared to the least deprived quartile (OR 0.77; 95% CI 0.70 to 0.86; p < 0.001). A 5% decrease in a patient being satisfied was observed for each decile increase in ADI (OR 0.95; 95% CI 0.94 to 0.96; p < 0.001). Conclusions: Social deprivation was an independent predictor of outpatient visit dissatisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey. These results necessitate consideration when developing health care delivery policies that serve to minimize inequalities between patients of differing socioeconomic groups.

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Section: Discussionmentioning

confidence: 91%

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Stephens

Potter

Tyser

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The cost of readmission penalties to hospitals and subsequently physician reimbursements were cut in half for hospital’s in the most deprived quintile as demonstrated by Joynt Maddox et al [ 78 ]. The importance of accounting for SES in evaluation of health care quality has also been demonstrated outside of the United States [ 79 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluating the impact of social deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Stephens

Potter

Tyser

et al. 2021

Health Qual Life Outcomes

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Background Social deprivation has been shown to affect access to health care services, and influences outcomes for a variety of physical and psychological conditions. However, the impact on patient satisfaction remains less clear. The objective of this study was to determine if social deprivation is an independent predictor of patient satisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS). Methods We retrospectively reviewed unique new adult patient (≥ 18 years of age) seen at a tertiary academic hospital and rural/urban outreach hospitals/clinics between January 2014 and December 2017. Satisfaction was defined a priori as achieving a score above the 33rd percentile. The 2015 Area Deprivation Index (ADI) was used to determine social deprivation (lower score signifies less social deprivation). Univariate and multivariable binary logistic regression were used to determine the impact of ADI on PGOMPS total and provider sub-scores while controlling for variables previously shown to impact scores (wait time, patient age, sex, race, specialty type, provider type, and insurance status). Results Univariate analysis of PGOMPS total scores revealed a 4% decrease in odds of patient satisfaction per decile increase in ADI (p < 0.001). Patients within the most deprived quartile were significantly less likely to report satisfaction compared to the least deprived quartile (OR 0.79, p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction decreased 2% for each decile increase in ADI on the Total Score (p < 0.001), independent of other variables previously shown to impact scores. For PGOMPS Provider Sub-Score, univariate analysis showed that patients in the lowest ADI quartile were significantly less likely be satisfied, as compared to the least deprived quartile (OR 0.77; 95% CI 0.70–0.86; p < 0.001). A 5% decrease in a patient being satisfied was observed for each decile increase in ADI (OR 0.95; 95% CI 0.94–0.96; p < 0.001). Conclusions Social deprivation was an independent predictor of outpatient visit dissatisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey. These results necessitate consideration when developing health care delivery policies that serve to minimize inequalities between patients of differing socioeconomic groups.

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“…Diagnosis-related groups (DRGs) payment have a signi cant impact on the hospital market. The indicator LOS is used to gain insight into quality and safety of medical care, which is one of the most crucial manifestations of DRGs [7]. Patient socioeconomic status appears to be associated with LOS and costs, which suggests ankle fracture patients may require reform to improve quality and e cacy.…”

Section: Introductionmentioning

confidence: 99%

Effect of enhanced recovery after surgery in the managements of ankle fracture patients: a single-center retrospective cohort study

Yao

Liu

et al. 2020

Preprint

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Background Ankle fracture is common and the treatment is embarrassed. Enhanced Recovery After Surgery (ERAS) has been successfully adopted for the improvement of efficacy and quality. However, application of ERAS in ankle fracture patients especially at the early stage is variable and remains to be clarified. We intent to explore the effect of ERAS among ankle fracture patients. Methods There were 29 male and 51 female patients aged 41.71 ± 14. 51 years who were consecutively grouped into non-ERAS group (n = 40) and ERAS group (n = 40). Univariate analysis and multiple linear regression analysis were applied to assess the association in outcomes and variables. Results AOFAS at post-operative 3 month (PO3M) and post-operative 6 month (PO6M), costs, length of stay (LOS), and pre-operative LOS were verified significantly in univariate analysis. Multiple linear regression analysis revealed that ERAS can improve American Orthopaedic Foot and Ankle Society (AOFAS) at PO3M (β = 7.06, 95% CI, 4.45–9.65) and PO6M (β = 5.08, 95% CI, 2.35–7.80), reduce costs (β = -6885.13, 95% CI, -12089.40 - -1680.85) and LOS (β = -3.27, 95% CI, -4.97 - -1.57) among ankle fracture patients. With the numbers available, no significant differences were observed (p༞0.05) for the AOFAS at post-operative 12 month (PO12M) and post-operative 24 month (PO24M), complications, or opioids consumption. Conclusion We found ERAS is superior to general protocol among proper ankle fracture patients, which can enhance rehabilitation especially at the early stage and improve medical quality and efficiency by reducing costs and LOS. ERAS protocol may have a promising future and worth promoting.

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Association of Pediatric Inpatient Socioeconomic Status With Hospital Efficiency and Financial Balance

Cited by 20 publications

References 38 publications

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Evaluating the impact of social deprivation on Press Ganey® Outpatient Medical Practice Survey Scores

Effect of enhanced recovery after surgery in the managements of ankle fracture patients: a single-center retrospective cohort study

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