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· DOS Abstracts
Socioeconomic inequality in patient outcome
among hip fracture patients: A population-based
cohort study
Pia Kjær Kristensen, Theis Muncholm Thillemann, Alma Becic Pedersen, Kjeld
Søballe, Søren Paaske Johnsen
Department of Orthopedic Surgery, Horsens Regional Hospital ; Department
of Orthopedic Surgery, Aarhus University Hospital ; Department of Clinical
Epidemiology, Aarhus University Hospital ; Department of Orthopedic Surgery,
Aarhus University Hospital ; Department of Clinical Epidemiology , Aarhus
University Hospital
Background:
Socioeconomic status influence the risk of hip fractures, but the
evidence is more limited and conflicting regarding the extent to which socio-
economic status will have an impact on quality of in-hospital care received and
survival after hip fracture.
Purpose / Aim of Study:
We examined the association between socioeco-
nomic status and 30-day mortality, acute readmission, quality of in-hospital
care, time to surgery and length of stay.
Materials and Methods:
A population-based cohort study using prospectively
collected data from the Danish Multidisciplinary Hip Fracture Registry. We iden-
tified 25,354 patients ¡Ý65 years admitted with a hip fracture between 2010
and 2013. From Statistic Denmark we assess data on socioeconomic status for
all patients including highest obtained education, family mean income, cohabit-
ing status and ethnicity. We performed multilevel regression analysis, controlling
for potential confounders.
Findings / Results:
Hip fracture patients with highest education had lower
30-day mortality compared to patients with low education (7.3% vs 10.0%
adjusted Odds Ratio (OR) = 0.74 (95 % confidence interval (CI) (0.63-0.88)).
Highest level of family income was also associated with lower 30-day mortal-
ity (11.9% vs 13.0 % adjusted OR = 0.77, 95 % CI 0.69-0.85). Cohabiting
status and ethnicity were not associated with 30-day mortality in the adjusted
analysis. Furthermore patients with both high education and high income had
lower risk of acute readmission (14.5% vs 16.9 % adjusted OR = 0.94, 95 % CI
0.91-0.97). Socioeconomic status was, however, not associated with quality of
in-hospital care, time to surgery and length of hospital stay.
Conclusions:
Higher education and higher family income was associated with
substantially lower 30-day mortality, but it could not be explained by differ-
ences in the provision of care during hospitalization.
No conflicts of interest reported
109.