Impact of social deprivation on quality indicators for the acute medical take

Social deprivation is a predictor of delivered care and clinical outcomes in many areas of medicine. It is not known whether social deprivation affects quality of care received by patients admitted as medical emergencies to hospitals in the United Kingdom (UK).

The Society for Acute Medicine's Benchmarking Audit (SAMBA) measures performance of Acute Medical Units in the UK during a 24-hour period. SAMBA23 took place on Thursday, 22 June 2023. Social deprivation was measured by matching the first half of patient postcodes with publicly available data about the Index of Multiple Deprivation for that geographic area.

SAMBA23 included 161 UK hospitals and 9612 patients. Data on social deprivation were available for 7855 patients. Patients from areas with the highest social deprivation were more frail and more likely to be admitted via the emergency department, as opposed to being referred by a General Practitioner. Patients from areas with the highest and lowest levels of deprivation received a similar standard of care as measured by three quality indicators; there were no statistically significant differences in the proportion of patients who received timely measurements of the National Early Warning Score, were seen within 4 hours by a clinician, and were reviewed in a timely manner by a consultant.

In this single 24-hour snapshot we were unable to identify differences in the delivery of the Acute Medical take in relation to the residential area index of multiple deprivation. Further research is required using patient level data. Key messages What is already known on this topic: Social deprivation is a co-factor for poor outcomes in most areas of medicine. It is unclear whether social deprivation influences the process of care and outcomes of patients admitted as medical emergencies. What this study adds: We found no evidence for an effect of the residential area index of multiple social deprivation on quality indicators for medical emergencies in data a single 24-hour snapshot as part of a national audit in Acute Medicine. How this study might affect research, practice or policy: This is the first published data from acute medical care in the UK looking at social deprivation, but more data is needed at individual patient level.