Evidence gaps among systematic reviews examining the relationship of race, ethnicity, and social determinants of health with adult inpatient quality measures.
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2024-01
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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.Type
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Advani, Sonali D, Alison G Smith, Alison G Smith, Ibukunoluwa C Kalu, Reinaldo Perez, Stephanie Hendren, Raymund B Dantes, Jonathan R Edwards, et al. (2024). Evidence gaps among systematic reviews examining the relationship of race, ethnicity, and social determinants of health with adult inpatient quality measures. Antimicrobial stewardship & healthcare epidemiology : ASHE, 4(1). p. e139. 10.1017/ash.2024.397 Retrieved from https://hdl.handle.net/10161/34411.
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Scholars@Duke
Sonali Advani
Dr. Advani is an Adjunct Associate Professor of Medicine at Duke University School of Medicine. In July 2024, she joined GSK/ViiV Healthcare as a scientific leadership physician with cross functional experience across global medical affairs as well as Research & Development in HIV therapeutics and vaccines.
Prior to this, she served as a physician investigator in the Duke Center for Antimicrobial Stewardship and Infection Prevention, a Fellow in Implementation Science at HIGH IRI (HIV, Infectious Disease and Global Health Implementation Research) Institute at Washington University, St Louis and Associate Medical Director of Infection Prevention at Yale New Haven Hospital. Her research focused on improving the diagnosis of UTIs in older adults, implementation of diagnostic stewardship interventions, and de-prescribing antibiotics for asymptomatic bacteriuria. She was awarded the K12 Urologic Career Development Award, Pepper Center Career Development Award, and SHEA Research Scholar Award to continue her UTI related research. In addition, she was one of the key investigators for CDC Prevention Epicenter Program and CDC SHEPheRD Contract for the Use of Race, Ethnicity, and Social Determinants of Health Data in NHSN Measures to Promote Health Equity.
Ibukun Christine Kalu
My research focus is on developing methods to prevent infections and improve treatment outcomes in children.
Reinaldo Perez
Steph Hendren
Steph is a Research and Education Librarian and liaison to the Doctor of Physical Therapy (DPT) and Occupational Therapy Doctorate (OTD) programs. She develops and teaches classes, conducts systematic reviews, and is engaged in research support and project consultations.
- MLIS, Library & Information Studies, University of Wisconsin Madison
- BA, English Literature, University of Wisconsin Madison
Deverick John Anderson
Hospital epidemiology, infection control, antibiotic stewardship, multidrug-resistant organisms, device-related infections, surgical site infections, catheter-associated bloodstream infections, cost of infections, infections in community hospitals
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