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. 2024 Sep 23;4(1):e139.
doi: 10.1017/ash.2024.397. eCollection 2024.

Evidence gaps among systematic reviews examining the relationship of race, ethnicity, and social determinants of health with adult inpatient quality measures

Sonali D Advani  1   2 , Alison G Smith  3 , Ibukunoluwa C Kalu  4 , Reinaldo Perez  1   2 , Stephanie Hendren  5 , Raymund B Dantes  6   7 , Jonathan R Edwards  6 , Minn Soe  6 , Sarah H Yi  6 , Janine Young  6   8 , Deverick J Anderson  1   2
Affiliations

Evidence gaps among systematic reviews examining the relationship of race, ethnicity, and social determinants of health with adult inpatient quality measures

Sonali D Advani et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Background: The field of healthcare epidemiology is increasingly focused on identifying, characterizing, and addressing social determinants of health (SDOH) to address inequities in healthcare quality. To identify evidence gaps, we examined recent systematic reviews examining the association of race, ethnicity, and SDOH with inpatient quality measures.

Methods: We searched Medline via OVID for English language systematic reviews from 2010 to 2022 addressing race, ethnicity, or SDOH domains and inpatient quality measures in adults using specific topic questions. We imported all citations to Covidence (www.covidence.org, Veritas Health Innovation) and removed duplicates. Two blinded reviewers assessed all articles for inclusion in 2 phases: title/abstract, then full-text review. Discrepancies were resolved by a third reviewer.

Results: Of 472 systematic reviews identified, 39 were included. Of these, 23 examined all-cause mortality; 6 examined 30-day readmission rates; 4 examined length of stay, 4 examined falls, 2 examined surgical site infections (SSIs) and one review examined risk of venous thromboembolism. The most evaluated SDOH measures were sex (n = 9), income and/or employment status (n = 9), age (n = 6), race and ethnicity (n = 6), and education (n = 5). No systematic reviews assessed medication use errors or healthcare-associated infections. We found very limited assessment of other SDOH measures such as economic stability, neighborhood, and health system access.

Conclusion: A limited number of systematic reviews have examined the association of race, ethnicity and SDOH measures with inpatient quality measures, and existing reviews highlight wide variability in reporting. Future systematic evaluations of SDOH measures are needed to better understand the relationships with inpatient quality measures.

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Conflict of interest statement

Dr Advani reports support from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK grant no. K12DK100024), Centers for Disease Control and Prevention grant no. 5U54CK000616-02, the Society for Healthcare Epidemiology of America, and the Duke Claude D. Pepper Older Americans Independence Center (National Institute on Aging grant no. P30AG028716), as well as consulting fees from Locus Biosciences (ended), Sysmex America (ended), GSK, bioMérieux, and the Infectious Diseases Society of America. Dr. Advani became an employee of GSK/ViiV Healthcare after this manuscript was accepted.

Figures

Figure 1.
Figure 1.
Flow diagram of the narrative review process.
See this image and copyright information in PMC

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