Socioeconomic Status and Outcome From Intensive Care in England and Wales

Bibliographic Data

ID9102488
AuthorsAndrew Hutchings (0000-0003-0215-9923, London School of Hygiene & Tropical Medicine, corresponding author), Rosalind Raine (0000-0003-0904-749X, London School of Hygiene & Tropical Medicine, corresponding author), Anthony Brady, Tony Brady (0000-0003-4751-7616, Intensive Care National Audit & Research Centre), Martin Wildman (0000-0002-1658-881X, London School of Hygiene & Tropical Medicine, corresponding author), Kathy Rowan (0000-0001-8217-5602, Intensive Care National Audit & Research Centre)
Year2004
Volume42
Issue10
Pages943-951
Publication date2004-10-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-200410000-00002
PMID15377926
OpenAlexW2042249041
LanguageEN
Citations received3
References cited35

OBJECTIVE: The objective of this study was to estimate the association between socioeconomic status (SES) and outcome for admissions to intensive care. RESEARCH DESIGN: Retrospective cohort study. SUBJECTS: We studied 51,572 admissions to 99 intensive-care units in England and Wales between 1995 and 2000. MEASURES: The SES of admissions was measured using Carstairs deprivation scores. Outcome was hospital mortality after adjustment for case mix using the APACHE II method. RESULTS: Admissions of lower SES were, on average, younger and less likely to be following surgery. There was evidence of a SES gradient for hospital mortality in admissions after elective surgery after adjusting for case mix (test for trend P <0.001), with higher SES associated with lower mortality. In the least-deprived quintile of SES, the odds ratio for hospital mortality was 0.70 (95% confidence interval, 0.58-0.84) compared with the most deprived quintile. There was no evidence of a SES gradient for hospital mortality in nonsurgical or emergency surgical admissions, and the decision to withdraw active treatment did not differ by SES. CONCLUSIONS: There is a SES gradient for hospital mortality in elective surgical admissions that is not explained by differences in case mix or the withdrawal of active treatment. Further research is required to establish if this finding can be explained by unmeasured differences in health status at admission to an intensive-care unit or differences in care and to establish the potential impact these results may have on interpreting comparative surgical performance data

Case mix index · Cohort study · Confidence interval · Environmental health · Intensive care · Intensive care medicine · Intensive care unit · Logistic regression · Odds · Odds ratio · Population · Retrospective cohort study · Socioeconomic status · Cardiac, Anesthesia and Surgical Outcomes · Demography · Emergency Medicine · Frailty in Older Adults · Internal Medicine · Medicine · Nursing · Sepsis Diagnosis and Treatment · Surgery

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