A Surgical Desirability of Outcome Ranking (DOOR) Reveals Complex Relationships Between Race/Ethnicity, Insurance Type, and Neighborhood Deprivation.

ABSTRACT:

Objective

Develop an ordinal Desirability of Outcome Ranking (DOOR) for surgical outcomes to examine complex associations of Social Determinants of Health.

Background

Studies focused on single or binary composite outcomes may not detect health disparities.

Methods

Three health care system cohort study using NSQIP (2013-2019) linked with EHR and risk-adjusted for frailty, preoperative acute serious conditions (PASC), case status and operative stress assessing associations of multilevel Social Determinants of Health of race/ethnicity, insurance type (Private 13,957; Medicare 15,198; Medicaid 2835; Uninsured 2963) and Area Deprivation Index (ADI) on DOOR and the binary Textbook Outcomes (TO).

Results

Patients living in highly deprived neighborhoods (ADI>85) had hi

SUBMITTER: Jacobs MA 

PROVIDER: S-EPMC10787813 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature