Area Deprivation Index Predicts Readmission Risk at an Urban Teaching Hospital

Abstract

A growing body of evidence has shown that neighborhood characteristics have significant effects on quality metrics that evaluate health plans or health care providers. Using a data set of an urban teaching hospital patient discharges, this study aimed to determine whether a significant effect of neighborhood characteristics, measured by the Area Deprivation Index, could be observed on patients’ readmission risk, independent of patient-level clinical and demographic factors. This study found that patients residing in more disadvantaged neighborhoods had significantly higher 30-day readmission risks compared to those living in less disadvantaged neighborhoods, even after accounting for individual-level factors. Those who lived in the most extremely socioeconomically challenged neighborhoods were 70% more likely to be readmitted than their counterparts who lived in less disadvantaged neighborhoods. These findings suggest that neighborhood-level factors should be considered along with individual-level factors in future work on adjustment of quality metrics for social risk factors.