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The relation between household income and surgical outcome in the Dutch setting of equal access to and provision of healthcare

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  • Klaas H J Ultee
  • Elke K M Tjeertes
  • Frederico Bastos Gonçalves
  • Ellen V Rouwet
  • Anton G M Hoofwijk
  • Robert Jan Stolker
  • Hence J M Verhagen
  • Sanne E Hoeks

Abstract

Background: The impact of socioeconomic disparities on surgical outcome in the absence of healthcare inequality remains unclear. Therefore, we set out to determine the association between socioeconomic status (SES), reflected by household income, and overall survival after surgery in the Dutch setting of equal access and provision of care. Additionally, we aim to assess whether SES is associated with cause-specific survival and major 30-day complications. Methods: Patients undergoing surgery between March 2005 and December 2006 in a general teaching hospital in the Netherlands were prospectively included. Adjusted logistic and cox regression analyses were used to assess the independent association of SES–quantified by gross household income–with major 30-day complications and long-term postoperative survival. Results: A total of 3929 patients were included, with a median follow-up of 6.3 years. Low household income was associated with worse survival in continuous analysis (HR: 1.05 per 10.000 euro decrease in income, 95% CI: 1.01–1.10) and in income quartile analysis (HR: 1.58, 95% CI: 1.08–2.31, first [i.e. lowest] quartile relative to the fourth quartile). Similarly, low income patients were at higher risk of cardiovascular death (HR: 1.26 per 10.000 decrease in income, 95% CI: 1.07–1.48, first income quartile: HR: 3.10, 95% CI: 1.04–9.22). Household income was not independently associated with cancer-related mortality and major 30-day complications. Conclusions: Low SES, quantified by gross household income, is associated with increased overall and cardiovascular mortality risks among surgical patients. Considering the equality of care provided by this study setting, the associated survival hazards can be attributed to patient and provider factors, rather than disparities in healthcare. Increased physician awareness of SES as a risk factor in preoperative decision-making and focus on improving established SES-related risk factors may improve surgical outcome of low SES patients.

Suggested Citation

  • Klaas H J Ultee & Elke K M Tjeertes & Frederico Bastos Gonçalves & Ellen V Rouwet & Anton G M Hoofwijk & Robert Jan Stolker & Hence J M Verhagen & Sanne E Hoeks, 2018. "The relation between household income and surgical outcome in the Dutch setting of equal access to and provision of healthcare," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-13, January.
    • Handle: RePEc:plo:pone00:0191464
    DOI: 10.1371/journal.pone.0191464
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    References listed on IDEAS

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    1. Silvia Stringhini & Valentin Rousson & Bharathi Viswanathan & Jude Gedeon & Fred Paccaud & Pascal Bovet, 2014. "Association of Socioeconomic Status with Overall and Cause Specific Mortality in the Republic of Seychelles: Results from a Cohort Study in the African Region," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-8, July.
    2. Hall, W.J. & Chapman, M.V. & Lee, K.M. & Merino, Y.M. & Thomas, T.W. & Payne, B.K. & Eng, E. & Day, S.H. & Coyne-Beasley, T., 2015. "Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review," American Journal of Public Health, American Public Health Association, vol. 105(12), pages 60-76.
    3. Katharine H Sharpe & Alex D McMahon & Gillian M Raab & David H Brewster & David I Conway, 2014. "Association between Socioeconomic Factors and Cancer Risk: A Population Cohort Study in Scotland (1991-2006)," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-15, February.
    4. Freimuth, V.S. & Quinn, S.C., 2004. "The contributions of health communication to eliminating health disparities," American Journal of Public Health, American Public Health Association, vol. 94(12), pages 2053-2055.
    5. Lynne F Forrest & Jean Adams & Helen Wareham & Greg Rubin & Martin White, 2013. "Socioeconomic Inequalities in Lung Cancer Treatment: Systematic Review and Meta-Analysis," PLOS Medicine, Public Library of Science, vol. 10(2), pages 1-25, February.
    6. Kilbourne, A.M. & Switzer, G. & Hyman, K. & Crowley-Matoka, M. & Fine, M.J., 2006. "Advancing health disparities research within the health care system: A conceptual framework," American Journal of Public Health, American Public Health Association, vol. 96(12), pages 2113-2121.
    7. Johnson, R.L. & Roter, D. & Powe, N.R. & Cooper, L.A., 2004. "Patient race/ethnicity and quality of patient-physician communication during medical visits," American Journal of Public Health, American Public Health Association, vol. 94(12), pages 2084-2090.
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