Measuring the association between diagnostic errors and neighborhood disadvantage

Patients who reside in areas of high neighborhood disadvantage have poorer health outcomes; the mechanisms for this disparity are complex. We sought to determine if there was an association between neighborhood disadvantage and diagnostic error among a cohort of adult inpatients who experienced either an ICU transfer or in-hospital death. Using a sample of 527 patients from seven geographically diverse academic medical systems, we compared diagnostic error rates to patients' neighborhood disadvantage levels as measured by the Area Deprivation Index, a validated composite measure of socioeconomic status. In contrast to previous studies that found differences in hospital care based on socioeconomic status, we found no difference in diagnostic error rate between patients based on neighborhood disadvantage. Once a patient reaches the hospital, their risk of diagnostic error is not related to the neighborhood in which they live.