• Kellia J Hansmann, W Ryan Powell, Blair P Golden, and KindAmy J HAJHCenter for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madis.
• Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
• J Hosp Med. 2022 Mar 1; 17 (3): 181185181-185.

AbstractNeighborhood disadvantage reflects historic and ongoing systemic injustices. Without addressing these upstream social determinants of health, hospitals may face different risk profiles for important quality metrics. Our objective was to assess differences in hospital characteristics where the proportion of patients residing in severely disadvantaged neighborhoods was high vs low. Using Medicare fee-for-service claims between January 1, 2014 and November 30, 2014 (5,807,499 hospital stays), we calculated Area Disadvantage Share (ADS), the proportion of each hospital's discharges to severely disadvantaged neighborhoods, for 4,528 hospitals. We examined hospital characteristics by distribution of ADS and by risk-adjusted 30-day readmission. Hospitals in the highest decile cared for a higher proportion of Black patients, were more often located in rural areas, and had higher patient risk of 30-day readmission compared to all other deciles. Hospitals face unequal burdens of neighborhood disadvantage, a factor distinct from other social determinants such as rurality.

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