title: Are hospital process quality indicators influenced by socio-demographic health determinants.
abstract: BACKGROUND
  This population-level health service study aimed to address whether hospitals assure the same quality of care to people in equal need, i.e. to see if any associations exist between social determinants and adherence to four hospital process indicators clearly identified as being linked to better health outcomes for patients.
  
  
  METHODS
  This was a retrospective cohort study based on administrative data collected in the Veneto Region (northeast Italy). We included residents of the Veneto Region hospitalized for ST-segment elevation myocardial infarction (STEMI) or acute myocardial infarction (AMI), hip fracture, or cholecystitis, and women giving birth, who were discharged from any hospital operating under the Veneto Regional Health Service between January 2012 and December 2012.
  
  
  METHODS
  The following quality indicator rates were calculated: patients with STEMI-AMI treated with percutaneous coronary intervention, elderly patients with hip fractures who underwent surgery within 48 h of admission, laparoscopic cholecystectomies and women who underwent cesarean section. A multilevel, multivariable logistic regression analyses were conducted to test the association between age, gender, formal education or citizenship and the quality of hospital care processes.
  
  
  RESULTS
  All the inpatient hospital care process quality indicators measured were associated with an undesirable number of disparities concerning the social determinants.
  
  
  CONCLUSIONS
  Monitoring the evidence-based hospital health care process indicators reveals undesirable disparities. Administrative data sets are of considerable practical value in broad-based quality assessments and as a screening tool, also in the health disparities domain.
authors: 1 Department of Molecular Medicine, Laboratory of Public Health and Population Studies, University of Padova, Padova, Italy alessandra.buja@unipd.it.
authors: Alessandra
authors: A
authors: Buja
authors: 2 Universida de Federal do Paraná, Setor Litoral Universidade Federal do Rio Grande do Sul, Curso de Saúde Coletiva, Brazil.
authors: Daniel
authors: D
authors: Canavese
authors: 1 Department of Molecular Medicine, Laboratory of Public Health and Population Studies, University of Padova, Padova, Italy.
authors: Patrizia
authors: P
authors: Furlan
authors: 3 Masters Course in Sciences of the Public Health and Prevention Professions, University of Padova, Padova, Italy.
authors: Laura
authors: L
authors: Lago
authors: 4 Heath Directorate, Veneto Region, Padova, Italy.
authors: Mario
authors: M
authors: Saia
authors: 1 Department of Molecular Medicine, Laboratory of Public Health and Population Studies, University of Padova, Padova, Italy.
authors: Vincenzo
authors: V
authors: Baldo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002585:Cesarean Section / Q000706:statistics & numerical data; D002764:Cholecystitis / Q000601:surgery; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006620:Hip Fractures / Q000601:surgery; D006761:Hospitals / Q000592:standards*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery; D011247:Pregnancy; D019984:Quality Indicators, Health Care / Q000592:standards; D011787:Quality of Health Care / Q000592:standards; D012189:Retrospective Studies; D064890:Social Determinants of Health / Q000706:statistics & numerical data