The following is a summary of “Association of upward economic mobility with textbook outcomes among patients undergoing general and cardiovascular surgery,” published in the MARCH 2023 issue of Surgery by Azap, et al.

For a study, researchers sought to investigate the association between upward economic mobility and postoperative outcomes among Medicare beneficiaries undergoing AAA, CABG, colectomy, or cholecystectomy and explore any racial disparities in this relationship.

The study utilized data from Medicare beneficiaries who underwent one of four surgical procedures from 2010 to 2016. The beneficiaries were stratified into quintiles based on their upward economic mobility, and the risk-adjusted probability of adverse postoperative outcomes was analyzed relative to economic mobility.

A total of 1,081,745 Medicare beneficiaries were included in the analysis, with a mean age of 75.5 years, 43.0% female, and 91.3% White. The study found that the risk-adjusted 30-day postoperative mortality decreased stepwise from 6.0% (5.9-6.1) in the lowest quintile of upward economic mobility OR:1.14 (95% CI:1.11–1.17)) to 5.3% (5.2-5.4) in the highest quintile. Similar trends were observed for postoperative complications (OR: 1.04, 95% CI: 1.02-1.06), extended length-of-stay (OR: 1.07, 95% CI: 1.06-1.09), and 30-day readmission (OR: 1.04, 95% CI: 1.02-1.05). In addition, black beneficiaries had a higher risk of postoperative mortality across all upward economic mobility quintiles except within the highest quintile (referent, White patients, OR: 0.93, 95% CI: 0.79-1.09, p = 0.355).

The study demonstrated that economic upward mobility was associated with better postoperative outcomes among Medicare beneficiaries. Racial disparities were also noted, with Black beneficiaries having a higher risk of postoperative mortality, except within the highest quintile of upward economic mobility. The findings highlighted the role of socioeconomics in achieving health equity among Medicare beneficiaries.

Source: americanjournalofsurgery.com/article/S0002-9610(22)00642-0/fulltext