ArticleSocial sciences & humanities open2026
Understanding the impact of socioeconomic deprivation on inpatient surgical care delivery costs in the Veterans Health Administration.
Article in Social sciences & humanities open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The impact of living in high neighborhood-level socioeconomic deprivation on inpatient surgery cost is not well known. This retrospective cohort study examines the relationship between the Area Deprivation Index (ADI) and noncardiac inpatient surgery costs in the Veterans Health Administration (VHA). Patients aged ≥65 years undergoing non-cardiac inpatient surgery during 2013-2019 were identified in Veterans Affairs Surgical Quality Improvement Program (VASQIP) data linked to additional VHA data sources. The cohort includes 136,631 predominantly male (97.7%) individuals with mean (SD) age of 72 (6.5) years. The 20,462 individuals with high ADI (>85) were more often Black race (27% vs 13.6%) with higher comorbidity burden (Gagne score 3.4 vs 3.1), higher frailty (29.1 vs 28.7), and more likely presenting with preoperative acute serious conditions (5.6% vs 4.5%) for more urgent (21.3% vs 18.7%) or emergent surgery (8.9% vs 8.1%, all p<0.001). After adjusting for facility and surgery year using regression, mean cost was $988 higher (95% CI: $657, $1319; p<0.001) for individuals with ADI>85. Using unconditional quantile regression, costs were even higher (>$1,600) for patients with ADI>85 at or above the 75
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