Area Deprivation Index Predicts Readmission Risk at an Urban Teaching Hospital

Am J Med Qual. Sep/Oct 2018;33(5):493-501. doi: 10.1177/1062860617753063. Epub 2018 Jan 22.


A growing body of evidence has shown that neighborhood characteristics have significant effects on quality metrics that evaluate health plans or health care providers. Using a data set of an urban teaching hospital patient discharges, this study aimed to determine whether a significant effect of neighborhood characteristics, measured by the Area Deprivation Index, could be observed on patients' readmission risk, independent of patient-level clinical and demographic factors. This study found that patients residing in more disadvantaged neighborhoods had significantly higher 30-day readmission risks compared to those living in less disadvantaged neighborhoods, even after accounting for individual-level factors. Those who lived in the most extremely socioeconomically challenged neighborhoods were 70% more likely to be readmitted than their counterparts who lived in less disadvantaged neighborhoods. These findings suggest that neighborhood-level factors should be considered along with individual-level factors in future work on adjustment of quality metrics for social risk factors.

Keywords: Area Deprivation Index; hospital readmission; neighborhood characteristics; quality of care; socioeconomic status.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Databases, Factual
  • Female
  • Hospitals, Teaching*
  • Hospitals, Urban
  • Humans
  • Male
  • Patient Readmission* / statistics & numerical data
  • Poverty Areas*
  • Quality of Health Care
  • Residence Characteristics
  • Risk Factors
  • Social Class