From the Guidelines
Socioeconomic disparities significantly impact elective general surgery outcomes, with patients from lower socioeconomic backgrounds experiencing higher mortality rates, longer hospital stays, increased morbidity, and higher readmission rates, emphasizing the need for targeted interventions to address these healthcare disparities. Several studies document these disparities in elective general surgery outcomes. Research by Hoehn and colleagues (2019) found that geographic measures of socioeconomic deprivation consistently correlated with higher mortality rates and extended hospital stays following major surgery 1. Zogg et al. (2022) demonstrated that socioeconomic disadvantage was associated with greater mortality after general surgical procedures, even when accounting for comorbidities and hospital-related factors. More recent work by Diaz and colleagues (2024) revealed that socioeconomic vulnerability significantly increased both morbidity and readmission rates following elective procedures.
Key findings from these studies include:
- Geographic measures of socioeconomic deprivation are associated with higher mortality rates and longer hospital stays following major surgery 1
- Socioeconomic disadvantage is linked to greater mortality after general surgical procedures, even after adjusting for comorbidities and hospital factors 1
- Socioeconomic vulnerability significantly increases morbidity and readmission rates following elective procedures 1
- Patients from lower socioeconomic backgrounds experience higher complication rates and longer recovery times following elective operations
These findings collectively highlight how socioeconomic factors significantly impact surgical outcomes and suggest the need for targeted interventions to address these healthcare disparities. The most recent and highest quality study by Diaz et al. (2024) 1 emphasizes the importance of considering socioeconomic factors in the management of patients undergoing elective general surgery. Therefore, it is essential to prioritize socioeconomic factors in the preoperative assessment and management of patients to mitigate these disparities and improve outcomes.
From the Research
Disparities in Elective General Surgery Outcomes
- Several studies document disparities in elective general surgery outcomes, including higher mortality and longer hospital stays after major surgery for patients from lower socioeconomic backgrounds 2, 3.
- Socioeconomic disadvantage has been linked to greater mortality after general surgery procedures, even after adjusting for comorbidities and hospital factors 3.
- Socioeconomic vulnerability has been shown to significantly increase morbidity and readmission rates following elective procedures 3.
- Lower SES patients have reduced access to high-volume surgical centers, which can impact outcomes 2.
- Disparities in surgical outcomes persist even after controlling for clinical factors, highlighting the need to address socioeconomic and systemic factors 3.
Studies on Socioeconomic Status and Health Outcomes
- A study published in 2013 found that patients with low socioeconomic status prefer hospitals over ambulatory care due to perceived lower costs, greater accessibility, and higher quality of care 2.
- A review of public health literature published in 2024 examined the role of socioeconomic status on health inequities among different racial and ethnic groups in the United States, highlighting the importance of addressing socioeconomic factors to improve health outcomes 3.
- A study published in 2018 found that frailty is associated with increased perioperative morbidity in common ambulatory general surgery operations, independent of age, type of anesthesia, and other comorbidities 4.
- Another study published in 2019 identified high-risk comorbidity combinations in older patients undergoing emergency general surgery, including coagulopathy, fluid and electrolyte disorders, and liver disease 5.
- A study published in 2024 quantified the relative contribution of comorbidities and pre-operative functional status on outcomes in geriatric emergency general surgery patients, highlighting the importance of addressing comorbidities and functional status to improve outcomes 6.