Association of Sociodemographic Factors With Overtriage, Undertriage, and Value of Care After Major Surgery
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View abstract on PubMed
Summary
This summary is machine-generated.Postoperative triage bias impacts patient outcomes and healthcare costs. Objective acuity assessments are crucial to ensure equitable care across all sociodemographic groups, preventing disparities in intensive care unit (ICU) admissions.
Area Of Science
- Healthcare Management
- Surgical Outcomes
- Health Equity
Background
- A fair healthcare system should not disproportionately affect patient subgroups.
- Overtriage (intensive care unit admission) and undertriage (general ward admission) can introduce inequities.
- Sociodemographic factors may influence triage decisions, impacting patient outcomes.
Purpose Of The Study
- To investigate if specific patient groups are vulnerable to incorrect postoperative triage decisions.
- To identify unique sociodemographic characteristics within overtriaged and undertriaged patient cohorts.
- To assess the impact of triage decisions on hospital mortality and value of care.
Main Methods
- A multicenter, longitudinal cohort study analyzed hospital admissions post-major surgery.
- Compared outcomes (hospital mortality, value of care) across four cohorts: overtriage, undertriage, and their respective controls.
- Utilized K-means clustering to identify sociodemographic phenotypes within triage cohorts.
Main Results
- Overtriaged patients were more likely male with commercial insurance; undertriaged patients were predominantly Black with higher socioeconomic deprivation.
- Overtriage increased costs and lowered value of care; undertriage increased mortality, hospice use, and lowered value of care.
- Identified unique sociodemographic phenotypes within both cohorts, with similar outcomes, indicating triage decisions, not patient characteristics, drove disparities.
Conclusions
- Postoperative triage decisions reveal significant sociodemographic disparities.
- Triage decisions, rather than inherent patient characteristics, appear to drive differential outcomes and value of care.
- Anchoring triage to objective acuity assessments is essential to mitigate bias and ensure equitable care.
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