@article{ref1,
title="Effects of socioeconomic position on 30-day mortality and wait for surgery after hip fracture",
journal="International journal for quality in health care",
year="2009",
author="Barone, Anna Patrizia and Fusco, Danilo and Colais, Paola and D'Ovidio, Mariangela and Belleudi, Valeria and Agabiti, Nera and Sorge, Chiara and Davoli, M. and Perucci, C. A.",
volume="21",
number="6",
pages="379-386",
abstract="OBJECTIVE: In countries where the National Health Service provides universal health coverage, socioeconomic position should not influence the quality of health care. We examined whether socioeconomic position plays a role in short-term mortality and waiting time for surgery after hip fracture. DESIGN: Retrospective cohort study. SETTING: and participants From the Hospital Information System database, we selected all patients, aged at least 65 years and admitted to acute care hospitals in Rome for a hip fracture between 1 January 2006 and 30 November 2007. The socioeconomic position of each individual was obtained using a city-specific index of socioeconomic variables based on the individual's census tract of residence. MAIN OUTCOME MEASURES: Three different outcomes were defined: waiting times for surgery, mortality within 30 days and intervention within 48 h of hospital arrival for hip fracture. We used a logistic regression to estimate 30-day mortality and a Cox proportional hazard model to calculate hazard ratios of intervention within 48 h. Median waiting times were estimated by adjusted Kaplan-Meyer curves. Analyses were adjusted for age, gender and coexisting medical conditions. RESULTS: Low socioeconomic level was significantly associated with higher risk of mortality [adjusted relative risk (RR) = 1.51; P < 0.05] and lower risk of early intervention (adjusted RR = 0.32; P < 0.001). Socioeconomic level had also an effect on waiting times within 30 days. CONCLUSIONS: Individuals living in disadvantaged census tracts had poorer prognoses and were less likely than more affluent people to be treated according to clinical guidelines despite universal healthcare coverage.<p /> <p>Language: en</p>",
language="en",
issn="1353-4505",
doi="10.1093/intqhc/mzp046",
url="http://dx.doi.org/10.1093/intqhc/mzp046"
}