Hospital quality, neighborhood deprivation linked to postop mortality

Editor's Note

This study led by researchers from the University of Michigan, Ann Arbor, finds that characteristics of patients’ neighborhoods and hospitals where they received treatment were both associated with postoperative mortality.

This analysis included 1,898,829 Medicare beneficiaries from all neighborhood types undergoing one of five common surgical procedures in hospitals across all quality levels.

The researchers found that 30-day, risk-adjusted postoperative mortality varied across high- and low-quality hospitals (4.3% vs 7.2%) and across the least- and most-deprived neighborhoods (4.5% vs 6.8%).

Comparing patients from the least-deprived neighborhoods going to high-quality hospitals vs patients from the most-deprived neighborhoods going to low-quality hospitals, the variation in postoperative mortality increased further (3.8% vs 8.1%).

The researchers concluded that efforts and investments to address variation in postoperative mortality should include both hospital quality improvement and drivers of neighborhood deprivation.