TY  - JOUR
PY  - 2009//
TI  - Effects of socioeconomic position on 30-day mortality and wait for surgery after hip fracture
JO  - International journal for quality in health care
A1  - Barone, Anna Patrizia
A1  - Fusco, Danilo
A1  - Colais, Paola
A1  - D'Ovidio, Mariangela
A1  - Belleudi, Valeria
A1  - Agabiti, Nera
A1  - Sorge, Chiara
A1  - Davoli, M.
A1  - Perucci, C. A.
SP  - 379
EP  - 386
VL  - 21
IS  - 6
N2  - 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>
LA  - en
SN  - 1353-4505
UR  - http://dx.doi.org/10.1093/intqhc/mzp046
ID  - ref1
ER  -