Supplemental Digital Content 11: Risk-Adjusted Rates of Outcomes for Emergency General Surgical Procedures by Subtheme Housing Type and TransportationVulnerability Quintiles
Housing type and transportationvulnerability quintile Risk-adjusted rate* (95% CI), % Odds ratio (95%
CI) p Value
Mortality, 30-d
Lowest housing type and transportation vulnerability†8.06 (7.95–8.17) Reference - Below average housing type and transportation
vulnerability‡ 8.24 (8.13–8.35) 1.03 (1.03–1.03) <0.001
Average housing type and transportation vulnerability§ 8.35 (8.24–8.46) 1.05 (1.04–1.05) <0.001 Above housing type and transportation vulnerability‖ 8.49 (8.37–8.60) 1.07 (1.06–1.07) <0.001 Highest housing type and transportation vulnerability¶ 8.61 (8.50–8.72) 1.08 (1.08–1.08) <0.001 Any complication
Lowest housing type and transportation vulnerability 34.52 (34.32–34.73) Reference - Below average housing type and transportation
vulnerability 35.24 (35.03–35.44) 1.04 (1.04–1.04) <0.001
Average housing type and transportation vulnerability 35.61 (35.41–35.82) 1.06 (1.06–1.06) <0.001 Above average housing type and transportation
vulnerability 36.06 (35.85–36.27) 1.08 (1.08–1.09) <0.001
Highest housing type and transportation vulnerability 36.48 (36.27–36.69) 1.11 (1.11–1.11) <0.001 Serious complication
Lowest housing type and transportation vulnerability 18.67 (18.47–18.86) Reference - Below average housing type and transportation
vulnerability 19.16 (18.96–19.35) 1.04 (1.03–1.04) <0.001
Average housing type and transportation vulnerability 19.42 (19.22–19.61) 1.05 (1.05–1.05) <0.001 Above average housing type and transportation
vulnerability 19.73 (19.53–19.93) 1.07 (1.07–1.08) <0.001
Highest housing type and transportation vulnerability 20.07 (19.87–20.28) 1.10 (1.10–1.10) <0.001 Reoperation
Lowest housing type and transportation vulnerability 11.98 (11.85–12.11) Reference - Below average housing type and transportation
vulnerability 12.11 (11.99–12.24) 1.01 (1.01–1.01) <0.001
Average housing type and transportation vulnerability 12.21 (12.08–12.34) 1.01 (1.01–1.01) <0.001 Above average housing type and transportation
vulnerability 12.31 (12.18–12.44) 1.02 (1.02–1.02) <0.001
Highest housing type and transportation vulnerability 12.30 (12.17–12.43) 1.02 (1.01–1.02) <0.001 Readmission
Lowest housing type and transportation vulnerability 15.14 (15.01–15.27) Reference - Below average housing type and transportation
vulnerability 15.42 (15.29–15.55) 1.02 (1.02–1.02) <0.001
Average housing type and transportation vulnerability 15.55 (15.42–15.68) 1.03 (1.03–1.03) <0.001 Above average housing type and transportation
vulnerability 15.73 (15.60–15.87) 1.05 (1.04–1.05) <0.001
Highest housing type and transportation vulnerability 15.92 (15.78–16.05) 1.06 (1.06–1.06) <0.001 Data Sources: Medicare Claims, 2014-2018; Social Vulnerability Index, 2018
Emergency general surgical procedures include appendectomy, cholecystectomy, colectomy, and ventral hernia repair
Housing type and transportation is 1 of the 4 Social Vulnerability subthemes and based on housing structure, crowding and vehicle access
*Model was adjusted for age, sex, year of procedure, patient to nurse ratio, hospital teaching status and Elixhauser comorbidity
†Lowest census-tract housing type and transportation vulnerability is defined as the lowest quintile by Social Vulnerability Index with subtheme score of 0 to 0.2.
‡Below average census-tract housing type and transportation vulnerability is defined as the quintile by Social Vulnerability Index with subtheme score of 0.21-0.40.
§Average census-tract housing type and transportation vulnerability is defined as the quintile by Social Vulnerability Index with subtheme score of 0.41-0.60.
‖Above average census-tract housing type and transportation vulnerability is defined as the quintile by Social Vulnerability Index with subtheme score of 0.61 to 0.80.
¶ Highest census-tract housing type and transportation vulnerability is defined as the highest quintile by Social Vulnerability Index with subtheme score of 0.81 to 1.
