#VisualAbstract: Safety-Net Hospitals, Neighborhood Disadvantage, and Readmissions Under Maryland’s All-Payer Program

1. In this retrospective observational study, the authors observed that residing in a disadvantaged neighborhood and being discharged from a safety-net hospital were independently associated with an increased 30-day risk of readmission.

2. There was a higher association observed between readmission risk and the hospital’s safety-net index compared to the patient’s neighborhood disadvantage status.

Evidence Rating Level: 2 (Good)

Study Rundown: The term safety-net hospital refers to a center that cares for a large number of significantly disadvantaged patients. The authors of this study evaluated the independent contributions of patients’ neighborhoods and the hospital’s service area with respect to the risk of 30-day readmission. The primary outcome measured was unplanned 30-day hospital readmission. Through this retrospective observational study, the authors found that residing in a disadvantaged neighborhood and being discharged from a safety net hospital were independently associated with an increased 30-day readmission risk among similar patients. Further, a greater association was found with the hospital’s safety-net index compared to the patient’s neighborhood disadvantage status. Since this study took place in Maryland, and involved residents discharged from a Maryland hospital in 2015, a main limitation of this study is its generalizability..

Click to read the study in Annals of Internal Medicine