The effect of socioeconomic status on outcomes for seriously ill patients: a linked data cohort study

Ho, Kwok M., Dobb, Geoffrey J., Knuiman, Matthew, Finn, Judith and Webb, Steven A. (2008) The effect of socioeconomic status on outcomes for seriously ill patients: a linked data cohort study. Medical Journal of Australia, 189 1: 26-30.

Author Ho, Kwok M.
Dobb, Geoffrey J.
Knuiman, Matthew
Finn, Judith
Webb, Steven A.
Title The effect of socioeconomic status on outcomes for seriously ill patients: a linked data cohort study
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2008-07
Sub-type Article (original research)
Open Access Status
Volume 189
Issue 1
Start page 26
End page 30
Total pages 5
Place of publication Strawberry Hills, NSW, Australia
Publisher Australasian Medical Publishing Company
Language eng
Formatted abstract
Objective: To investigate the association between socioeconomic status (SES) and outcomes for seriously ill patients.

Design and setting: A retrospective cohort study based on data from an intensive care unit clinical database linked with data from the Western Australian hospital morbidity and mortality databases over a 16-year period (1987-2002).

Main outcome measures: In-hospital and long-term mortality.

Results: Data on 15619 seriously ill patients were analysed. The in-hospital mortality rate for all seriously ill patients was 14.8%, and the incidence of death after critical illness was 7.4 per 100 person-years (4.8 per 100 person-years after hospital discharge). Patients from the most socioeconomically disadvantaged areas were more likely to be younger, to be Indigenous, to live in a remote area, to be admitted non-electively, and to have more severe acute disease and comorbidities. SES was not significantly associated with in-hospital mortality, but long-term mortality was significantly higher in patients from the lowest SES group than in those from the highest SES group, after adjusting for age, ethnicity, comorbidities, severity of acute illness, and geographical accessibility to essential services (hazard ratio for death in lowest SES group v highest SES group was 1.21 [95% CI, 1.04-1.41]; P = 0.014). The attributable incidence of death after hospital discharge between patients from the lowest and highest SES groups was 1.0 per 100 person-years (95% CI, 0.3-1.6 per 100 person-years).

Conclusion: Lower SES was associated with worse long-term survival after critical illness over and above the background effects of age, acuity of acute illness, comorbidities, Indigenous status and geographical access to essential services. 
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Nursing, Midwifery and Social Work Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 14 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 0 times in Scopus Article
Google Scholar Search Google Scholar
Created: Thu, 31 Jul 2014, 14:32:34 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work