Evidence map›Paper›PMID 38991688›Full record

ArticleBMJ open2024

Synergistic effects of social determinants of health and race-ethnicity on 30-day all-cause readmission disparities: a retrospective cohort study.

Wan-Ting K Su, Cara Cannella, Jessica Haeusler, Indra Adrianto, Ilan Rubinfeld, Albert M Levin

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Wan-Ting K SuDivision of Biomedical Informatics, Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA wsu1@hfhs.org.ORCID 0000-0002-7395-9912
Cara CannellaCenter for Bioinformatics, Henry Ford Health, Detroit, Michigan, USA.
Jessica HaeuslerClinical and Quality Analytics, Henry Ford Health, Detroit, Michigan, USA.
Indra AdriantoDivision of Biomedical Informatics, Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA.
Ilan RubinfeldAdministration, Henry Ford Hospital, Detroit, Michigan, USA.
Albert M LevinDivision of Biomedical Informatics, Department of Public Health Sciences, Henry Ford Health, Detroit, Michigan, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe objective of this study is to assess the effects of social determinants of health (SDOH) and race-ethnicity on readmission and to investigate the potential for geospatial clustering of patients with a greater burden of SDOH that could lead to a higher risk of readmission.

designA retrospective study of inpatients at five hospitals within Henry Ford Health (HFH) in Detroit, Michigan from November 2015 to December 2018 was conducted.

settingThis study used an adult inpatient registry created based on HFH electronic health record data as the data source. A subset of the data elements in the registry was collected for data analyses that included readmission index, race-ethnicity, six SDOH variables and demographics and clinical-related variables.

participantsThe cohort was composed of 248 810 admission patient encounters with 156 353 unique adult patients between the study time period. Encounters were excluded if they did not qualify as an index admission for all payors based on the Centers for Medicare and Medicaid Service definition.

main outcome measureThe primary outcome was 30-day all-cause readmission. This binary index was identified based on HFH internal data supplemented by external validated readmission data from the Michigan Health Information Network.

resultsRace-ethnicity and all SDOH were significantly associated with readmission. The effect of depression on readmission was dependent on race-ethnicity, with Hispanic patients having the strongest effect in comparison to either African Americans or non-Hispanic whites. Spatial analysis identified ZIP codes in the City of Detroit, Michigan, as over-represented for individuals with multiple SDOH.

conclusionsThere is a complex relationship between SDOH and race-ethnicity that must be taken into consideration when providing healthcare services. Insights from this study, which pinpoint the most vulnerable patients, could be leveraged to further improve existing models to predict risk of 30-day readmission for individuals in future work.

Indexed as

Patient ReadmissionSocial Determinants of HealthAdultAgedEthnicityFemaleHealthcare DisparitiesHealth Status DisparitiesHumansMaleMichiganMiddle AgedRacial GroupsRetrospective StudiesUnited StatesElectronic Health RecordsHealth EquityRetrospective Studies

Identifiers

PMID38991688
PMCPMC11284929

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.