Effect of poverty on surgical care, postop outcomes

Editor's Note

This study from the Ohio State University Wexner Medical Center, Columbus, examines the association between long-standing poverty and postoperative outcomes.

The analysis included 335, 595 patients who underwent lung resection, colectomy, coronary artery bypass grafting, or lower extremity joint replacement, and who were categorized according to the duration of poverty status (ie, never high poverty or persistent poverty) from 1980 to 2015.

Among the findings:

• 80.3% lived in never high poverty and 4.4% lived in persistent poverty counties
• Patients living in persistent poverty were at increased risk of serious postoperative complications, 30-day readmissions, 30-day mortality, and higher expenditures
• Postoperative poverty was associated with lower odds of achieving textbook outcomes, with 65% of this effect mediated by other socioeconomic factors
• Minority patients were less likely to achieve textbook outcomes, and the disparity persisted across all poverty categories.

The researchers concluded that county-level persistent poverty duration was associated with adverse postoperative outcomes and higher expenditures, and the effects were more pronounced among minority patients.