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RACS ASC 2024

Achieving Equity: Patient Demographics and Outcomes after Surgical and Non-Surgical Procedures in South Australia, 2022

Verbal Presentation

Verbal Presentation

2:10 pm

07 May 2024

Bealey 3

RESEARCH PAPERS

Disciplines

General Surgery

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Presentation Description

Institution: University of Adelaide - SA, Australia

Background To improve health equity, this study aimed to identify patient demographic characteristics that might predict disparities in mortality, readmission, and discharge outcomes after either an operative or non-operative procedural hospital admission. Methods This retrospective cohort study included all surgical and non-surgical procedural admissions at three of the four major metropolitan public hospitals in South Australia in 2022. Multivariable logistic regression, with backwards selection, evaluated association between patient demographic characteristics and outcomes up to 90 days post-procedurally. Results 40,882 admissions were included. Increased likelihood of all-cause, post-procedure mortality in-hospital, at 30 days, and 90 days, were significantly associated with increased age (p<0.001), increased comorbidity burden (p<0.001), an emergency admission (p<0.001), and male sex (p=0.046, p=0.03, p<0.001, respectively). Identification as ATSI (p<0.001) and being born in Australia (p=0.03, p=0.001, respectively) were associated with an increased likelihood of 30-day hospital readmission and decreased likelihood of discharge directly home, as was increased comorbidity burden (p<0.001) and emergency admission (p<0.001). Being married (p<0.001) and male sex (p=0.003) were predictive of an increased likelihood of discharging directly home; in contrast to increased age (p<0.001) which was predictive of decreased likelihood of this occurring. Conclusions This study characterised several associations between patient demographic factors present on admission and outcomes after surgical and non-surgical procedures, that can be integrated within patient flow pathways through the Australian healthcare system to improve healthcare equity.

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Authors

Dr Joshua Kovoor - , Dr Aashray Gupta - , Dr Stephen Bacchi - , Dr Brandon Stretton - , Prof Gerry O'Callaghan - , Dr Elizabeth Murphy - , Prof Thomas Hugh - , Prof Robert Padbury - , Dr Markus Trochsler - , Prof Guy Maddern -