Disparities in surgical outcomes for low socioeconomic status patients in Australia

de Jager, Elzerie, Gunnarsson, Ronny, and Ho, Yik-Hong (2022) Disparities in surgical outcomes for low socioeconomic status patients in Australia. ANZ Journal of Surgery, 92 (5). pp. 1026-1032.

[img] PDF (Published Version) - Published Version
Restricted to Repository staff only

View at Publisher Website: https://doi.org/10.1111/ans.17675


Background: There are disparities in surgical outcomes for patients of low socioeconomic status globally, including in countries with universal healthcare systems. There is limited data on the impact of low socioeconomic status on surgical outcomes in Australia. This study examines surgical outcomes by both self-reported unemployment and neighbourhood level socioeconomic status in Australia.

Methods: A retrospective administrative data review was conducted at a tertiary care centre over a 10-year period (2008–2018) including all adult surgical patients. Multivariable logistic regression adjusting for year, age, sex and Charlson Comorbidity Index was performed.

Results: 106 197 patients underwent a surgical procedure in the decade examined. The overall adverse event rates were mortality (1.13%), total postoperative complications (10.9%), failure to rescue (0.75%) and return to theatre (4.31%). Following multivariable testing, unemployed and low socioeconomic patients had a higher risk of postoperative mortality (OR 2.06 (1.50–2.82), OR 1.37 (1.15–1.64)), all complications (OR 1.43 (1.31–1.56), OR 1.21 (1.14–1.28)), failure to rescue (OR 2.03 (1.39–2.95), OR 1.38 (1.11–1.72)) and return to theatre (OR 1.42 (1.27–1.59), OR 1.24 (1.14–1.36)) (P < 0.005 for all).

Conclusions: Despite universal healthcare, there are disparities in surgical adverse events for patients of low socioeconomic status in Australia. Disparities in surgical outcomes can stem from three facets: a patient's access to healthcare (the severity of disease at the time of presentation), variation in perioperative care delivery, and social determinants of health. Further work is required to pinpoint why these disparities are present and to evaluate the impact of strategies that aim to reduce disparities.

Item ID: 74514
Item Type: Article (Research - C1)
ISSN: 1445-2197
Keywords: disparities, socioeconomic status, surgery, surgical outcomes, unemployed
Copyright Information: © 2022 The Authors. ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgery.
Date Deposited: 01 Nov 2022 00:45
FoR Codes: 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320226 Surgery @ 80%
42 HEALTH SCIENCES > 4206 Public health > 420602 Health equity @ 20%
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page