Using the Social Vulnerability Index to Analyze Statewide Health Disparities in Cholecystectomy

Area of Science:

• Health Services Research
• Surgical Outcomes
• Health Equity

Background:

• Social determinants of health significantly impact surgical care access.
• The Social Vulnerability Index (SVI) is a tool to assess population vulnerability.
• Understanding SVI's role in surgical decision-making is crucial for addressing health disparities.

Purpose of the Study:

• To evaluate the utility of the Social Vulnerability Index (SVI) in predicting cholecystectomy receipt among patients with cholecystitis in Texas.
• To determine if higher social vulnerability is associated with lower rates of undergoing this common surgical procedure.

Main Methods:

• Retrospective analysis of adult patients diagnosed with cholecystitis in Texas (2016-2019).
• Patients were stratified into quartiles based on their Social Vulnerability Index (SVI) scores.
• Relative risk (RR) of undergoing cholecystectomy was calculated, comparing different SVI vulnerability levels.

Main Results:

• Over 72% of 67,548 assessed patients underwent cholecystectomy.
• Patients in the lowest SVI quartile (low vulnerability) were more likely to receive surgery (RR=1.21).
• Conversely, patients in the highest SVI quartile (high vulnerability) were less likely to receive surgery (RR=0.91).
• These associations persisted after adjusting for demographic and insurance factors, but were less pronounced in rural areas.

Conclusions:

• Higher Social Vulnerability Index scores are associated with a decreased likelihood of receiving an elective cholecystectomy.
• The SVI is a valuable tool for identifying social determinants that influence access to and receipt of surgical care.
• Targeted interventions may be needed to mitigate SVI-related disparities in surgical care for conditions like cholecystitis.