The impact of social deprivation on healthcare utilization patterns following rotator cuff repair. J Shoulder Elbow Surg 2024 Nov;33(11):2421-2426
Date
03/30/2024Pubmed ID
38552776DOI
10.1016/j.jse.2024.01.038Scopus ID
2-s2.0-85194180858 (requires institutional sign-in at Scopus site) 1 CitationAbstract
BACKGROUND: Disparities in social determinants of health have been linked to worse patient reported outcomes, higher pain, and increased risk of revision surgery following rotator cuff repair. Identification of perioperative predictors of increased healthcare utilization is of particular interest to surgeons to improve outcomes and mitigate the total cost of care. The effect of social deprivation on healthcare utilization has not been fully characterized.
METHODS: This is a retrospective review of a single institution's experience with primary rotator cuff repair between 2012 and 2020. Demographic variables (age, race, gender, American Society of Anesthesiologists (ASA) score) and healthcare utilization (hospital readmission, emergency department visits, follow-up visits, telephone calls) were recorded within 90 days of surgery. The Area Deprivation Index (ADI) was recorded, and patients were separated into terciles according to their relative level of social deprivation. Outcomes were then stratified based on ADI tercile and compared.
RESULTS: A total of 1695 patients were included. The upper, middle, and lower terciles of ADI consisted of 410, 767, and 518 patients, respectively. The most deprived tercile had greater emergency department visitation and office visitation within 90 days of surgery relative to the least and intermediate deprived terciles. Higher levels of social deprivation were independent risk factors for increased emergency department (ED) visitation and follow-up visitation. There was no difference in 90-day readmission rates or telephone calls made between the least, intermediate, and most deprived patients.
CONCLUSIONS: Patients with higher levels of deprivation demonstrated greater postoperative hospital utilization. We hope to use these results to identify risk factors for increased hospital use, guide clinical decision making, increase transparency, and manage patient outcomes following rotator cuff repair surgery.
Author List
Van Boxtel M, Cinquegrani E, Middleton A, Graf A, Hanley J, LoGiudice AAuthors
Jessica M. Hanley MD Associate Professor in the Orthopaedic Surgery department at Medical College of WisconsinAnthony J. LoGiudice MD Associate Professor in the Orthopaedic Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedEmergency Service, Hospital
Female
Humans
Male
Middle Aged
Patient Acceptance of Health Care
Patient Readmission
Retrospective Studies
Rotator Cuff Injuries
