Does socioeconomic status affect mortality subsequent to hospital admission for community acquired pneumonia among older persons?
BACKGROUND
Low socioeconomic status has been associated with increased morbidity and mortality for various health conditions. The purpose of this study was twofold: to examine the mortality experience of older persons admitted to hospital with community acquired pneumonia and to test the hypothesis of whether an association exists between socioeconomic status and mortality subsequent to hospital admission for community-acquired pneumonia.


METHODS
A population based retrospective cohort study was conducted including all older persons patients admitted to Ontario hospitals with community acquired pneumonia between April 1995 and March 2001. The main outcome measures were 30 day and 1 year mortality subsequent to hospital admission for community-acquired pneumonia.


RESULTS
Socioeconomic status for each patient was imputed from median neighbourhood income. Multivariate analyses were undertaken to adjust for age, sex, co-morbid illness, hospital and physician characteristics. The study sample consisted of 60,457 people. Increasing age, male gender and high co-morbidity increased the risk for mortality at 30 days and one year. Female gender and having a family physician as attending physician reduced mortality risk. The adjusted odds of death after 30-days for the quintiles compared to the lowest income quintile (quintile 1) were 1.02 (95% CI: 0.95-1.09) for quintile 2, 1.04 (95% CI: 0.97-1.12) for quintile 3, 1.01 (95% CI: 0.94-1.08) for quintile 4 and 1.03 (95% CI: 0.96-1.12) for the highest income quintile (quintile 5). For 1 year mortality, compared to the lowest income quintile the adjusted odds ratios were 1.01 (95% CI: 0.96-1.06) for quintile 2, 0.99 (95% CI: 0.94-1.04) for quintile 3, 0.99 (95% CI: 0.93-1.05) for quintile 4 and 1.03 (95% CI: 0.97-1.10) for the highest income quintile.


CONCLUSIONS
Socioeconomic status is not associated with mortality in the older persons from community-acquired pneumonia in Ontario, Canada.
Vrbova
Linda
L
Department of Public Health Sciences, University of Toronto, McMurrich Building, 12 Queen's Park Crescent W, Toronto, ON, M5S 1A8, Canada. linda.Vrbova@moh.gov.on.ca
Mamdani
Muhammad
M
Moineddin
Rahim
R
Jaakimainen
Liisa
L
Upshur
Ross E G
RE
D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000401:mortality* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission; D011014:Pneumonia / Q000401:mortality* / Q000628:therapy; D012923:Social Class; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome