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The impact of socioeconomic status on emergency department outcome in a low-income country setting: A registry-based analysis

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  • Vijay C Kannan
  • Giannie N Rasamimanana
  • Victor Novack
  • Lior Hassan
  • Teri A Reynolds

Abstract

Background: The impact of socioeconomic status on health has been established via a broad body of literature, largely from high-income countries. Investigative efforts in low- and middle-income countries have suffered from a lack of reporting standardization required to draw comparisons across countries of varying economic strata. In this study we aimed to evaluate the impact of socioeconomic status on emergency department outcomes in a low-income African country using international data classification systems. Methods: This was a retrospective cohort study was conducted at a tertiary care center in northern Madagascar. Data were abstracted from paper charts into an electronic registry using Integrated Public Use Microdata Series codes for occupation, Nam-Powers-Boyd (NPB) scores for socioeconomic status, and Clinical Classifications Software ICD-9 equivalents for diagnosis. Outcome was dichotomized to the combined disposition of death or transfer directly to operating theater (OT) versus discharge. We used t-tests to compare baseline characteristics between these groups. We used chi-square analysis to test the association between occupational class and diagnosis. Finally, multivariate logistic regression analysis was performed examining the impact of NPB score on death/OT outcome, adjusting for age, gender, diagnosis and occupation. Results: 5271 patients were seen during the 21-month study period with a death/OT rate of 9.7%. Older age and male gender were more common in death/OT patients (both p

Suggested Citation

  • Vijay C Kannan & Giannie N Rasamimanana & Victor Novack & Lior Hassan & Teri A Reynolds, 2019. "The impact of socioeconomic status on emergency department outcome in a low-income country setting: A registry-based analysis," PLOS ONE, Public Library of Science, vol. 14(10), pages 1-11, October.
    • Handle: RePEc:plo:pone00:0223045
    DOI: 10.1371/journal.pone.0223045
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    References listed on IDEAS

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    1. Signorello, L.B. & Cohen, S.S. & Williams, D.R. & Munro, H.M. & Hargreaves, M.K. & Blot, W.J., 2014. "Socioeconomic status, race, and mortality: A prospective cohort study," American Journal of Public Health, American Public Health Association, vol. 104(12), pages 98-107.
    2. 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.
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