Influence of social factors on avoidable mortality: a hospital-based case-control study.
OBJECTIVE
The effect of socioeconomic factors on avoidable mortality at an individual level is not well known, since most studies showing this association are based on aggregate data. The purpose of this study was to determine socioeconomic differences between those patients who die of avoidable causes and those who do not die.


METHODS
A matched case-control study was carried out regarding in-hospital avoidable mortality (Holland's medical care indicators) that occurred in a university hospital serving a Spanish-Mediterranean population during a 30-month period.


RESULTS
We studied 82 cases of death from avoidable causes and 300 controls matched on medical care indicators and age. The variables that showed a statistically significant association with in-hospital avoidable mortality were number of diagnoses (the greater the number, the higher the risk), length of stay (patients staying seven or more days presented a lower risk), and education. Those patients with low and middle educational levels showed a greater risk of avoidable mortality (adjusted odds ratio=3.57 and 2.82, respectively) than those patients with higher levels of education.


CONCLUSIONS
Consistent with the findings of studies based on aggregate data, our case-control analyses indicated that among several socioeconomic variables studied, educational level was significantly associated with the risk of in-hospital avoidable mortality, regardless of age and medical care indicators. Patients with low levels of education (<6 years of schooling) were at highest risk for in-hospital avoidable mortality, followed by those with middle levels of education (7-10 years of schooling).
Bautista
Daniel
D
Department of Preventive Medicine, Dr. Peset University Hospital, Valencia, Spain. bautista_dan@gva.es
Alfonso
José Luis
JL
Corella
Dolores
D
Saiz
Carmen
C
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016555:Matched-Pair Analysis; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology
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