Area Deprivation Index Predicts Readmission Risk at an Urban Teaching Hospital

TLDR

Neighborhood characteristics significantly influence health care quality metrics, affecting evaluations of health plans and providers. The study aimed to determine whether neighborhood characteristics measured by the Area Deprivation Index affect patients' readmission risk independent of clinical and demographic factors. The authors used a dataset of urban teaching hospital patient discharges to assess this relationship. Patients from more disadvantaged neighborhoods had significantly higher 30‑day readmission risks, with those in the most socioeconomically challenged areas being 70% more likely to be readmitted, indicating that neighborhood-level factors should be considered alongside individual-level factors in quality metric adjustments.

Abstract

A growing body of evidence has shown that neighborhood characteristics have significant effects on quality metrics that evaluate health plans or health care providers. Using a data set of an urban teaching hospital patient discharges, this study aimed to determine whether a significant effect of neighborhood characteristics, measured by the Area Deprivation Index, could be observed on patients' readmission risk, independent of patient-level clinical and demographic factors. This study found that patients residing in more disadvantaged neighborhoods had significantly higher 30-day readmission risks compared to those living in less disadvantaged neighborhoods, even after accounting for individual-level factors. Those who lived in the most extremely socioeconomically challenged neighborhoods were 70% more likely to be readmitted than their counterparts who lived in less disadvantaged neighborhoods. These findings suggest that neighborhood-level factors should be considered along with individual-level factors in future work on adjustment of quality metrics for social risk factors.