ArticlePloS one2018
The relation between household income and surgical outcome in the Dutch setting of equal access to and provision of healthcare.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 33 citations in OpenAlex.
- Social deprivation and morbidity and mortality after surgery: a UK national observational cohort study.British journal of anaesthesia · 2025Observational
- The Influence of Hospital Type, Insurance Type, and Patient Income on 30-Day Complication and Readmission Rates Following Lumbar Spine Fusion.Global spine journal · 2025Article
- Hospital volume-outcome relationships for robot-assisted surgeries: a population-based analysis.Surgical endoscopy · 2024Article
- The effects of social determinants of health on rotator cuff repair utilization and outcomes: a systematic review.JSES reviews, reports, and techniques · 2024Review
- Hospital learning curves for robot-assisted surgeries: a population-based analysis.Surgical endoscopy · 2024Article
- Risk Factors for Nonresilient Outcomes in Older Adults After Total Knee Replacement.The journals of gerontology. Series A, Biological sciences and medical sciences · 2022Article
- Impact of the Covid-19 pandemic on rates of emergency department utilization and hospital admission due to general surgery conditions.Surgical endoscopy · 2022Article
- Effect of Household Income on Short-Term Outcomes Following Cerebellopontine Angle Tumor Resection.Journal of neurological surgery. Part B, Skull base · 2022Article
- Disparities in surgical outcomes for low socioeconomic status patients in Australia.ANZ journal of surgery · 2022Article
- Risk factors of postoperative complications following total knee arthroplasty in Korea: A nationwide retrospective cohort study.Medicine · 2021Observational
- The Influence of Household Income on Survival following Posterior Fossa Tumor Resection at a Large Academic Medical Center.Journal of neurological surgery. Part B, Skull base · 2021Article
- Declining Rates of Surgery for Inflammatory Bowel Disease in the Era of Biologic Therapy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- Low Socioeconomic Status Is Associated with Worse Outcomes After Curative Surgery for Colorectal Cancer: Results from a Large, Multicenter Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
- The Impact of Household Economics on Short-Term Outcomes in a Posterior Fossa Tumor Population.Cureus · 2020Article
- Previous Use of Mammography as a Proxy for General Health Checks in Association with Better Outcomes after Major Surgeries.International journal of environmental research and public health · 2019Article
- Risk Factors, Causes, and Costs of Hospital Readmission After Head and Neck Cancer Surgery Reconstruction.JAMA facial plastic surgery · 2019Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of socioeconomic disparities on surgical outcome in the absence of healthcare inequality remains unclear. Therefore, we set out to determine the association between socioeconomic status (SES), reflected by household income, and overall survival after surgery in the Dutch setting of equal access and provision of care. Additionally, we aim to assess whether SES is associated with cause-specific survival and major 30-day complications.
methodsPatients undergoing surgery between March 2005 and December 2006 in a general teaching hospital in the Netherlands were prospectively included. Adjusted logistic and cox regression analyses were used to assess the independent association of SES-quantified by gross household income-with major 30-day complications and long-term postoperative survival.
resultsA total of 3929 patients were included, with a median follow-up of 6.3 years. Low household income was associated with worse survival in continuous analysis (HR: 1.05 per 10.000 euro decrease in income, 95% CI: 1.01-1.10) and in income quartile analysis (HR: 1.58, 95% CI: 1.08-2.31, first [i.e. lowest] quartile relative to the fourth quartile). Similarly, low income patients were at higher risk of cardiovascular death (HR: 1.26 per 10.000 decrease in income, 95% CI: 1.07-1.48, first income quartile: HR: 3.10, 95% CI: 1.04-9.22). Household income was not independently associated with cancer-related mortality and major 30-day complications.
conclusionsLow SES, quantified by gross household income, is associated with increased overall and cardiovascular mortality risks among surgical patients. Considering the equality of care provided by this study setting, the associated survival hazards can be attributed to patient and provider factors, rather than disparities in healthcare. Increased physician awareness of SES as a risk factor in preoperative decision-making and focus on improving established SES-related risk factors may improve surgical outcome of low SES patients.
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