Background
Methods
Hospital Episode Statistics (HES)
Procedures and database inclusions
Measures of inequalities
Dependent variables: process and outcome measures
Data analysis
Power and sample size calculations
Results
Characteristics of the population
Bariatric Surgery | Cholecystectomy | Coronary Angioplasty | Hip replacement | Inguinal hernia | Knee replacement | Mastectomy | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Number of admissions
| 543 | 958 | 2238 | 778 | 1129 | 1303 | ||||||||
Number of patients
| 533 | 955 | 2060 | 734 | 872 | 1018 | 1104 | |||||||
Age Group
|
N
|
%
|
N
|
%
|
N
|
%
|
N
|
%
|
N
|
%
|
N
|
%
|
N
|
%
|
18-24 | 20 | 3.8 | 29 | 3.0 | 0 | 0.0 | 2 | 0.3 | 18 | 2.0 | 0 | 0.0 | 4 | 0.3 |
25-34 | 77 | 14.2 | 169 | 17.6 | 6 | 0.3 | 14 | 1.8 | 61 | 6.8 | 2 | 0.2 | 31 | 2.4 |
35-44 | 180 | 33.1 | 177 | 18.5 | 50 | 1.2 | 48 | 6.2 | 105 | 11.7 | 11 | 1.0 | 142 | 10.9 |
45-54 | 168 | 30.9 | 218 | 22.8 | 296 | 13.2 | 86 | 11.1 | 116 | 12.9 | 79 | 7.0 | 381 | 29.2 |
55-64 | 80 | 14.7 | 166 | 17.3 | 681 | 30.4 | 189 | 24.3 | 199 | 22.1 | 290 | 25.7 | 388 | 29.8 |
65-74 | 18 | 3.3 | 134 | 14.0 | 801 | 35.8 | 239 | 30.7 | 225 | 25.0 | 427 | 37.8 | 237 | 18.2 |
75-84 | 0 | 0.0 | 62 | 6.5 | 365 | 16.3 | 166 | 21.3 | 133 | 14.8 | 275 | 24.4 | 98 | 7.5 |
85+ | 0 | 0.0 | 3 | 0.3 | 39 | 1.7 | 34 | 4.4 | 43 | 4.8 | 45 | 4.0 | 22 | 1.7 |
Sex
| ||||||||||||||
Male | 116 | 21.4 | 250 | 26.1 | 1680 | 75.1 | 346 | 44.5 | 819 | 91.0 | 349 | 30.9 | 0 | 0.0 |
Female | 427 | 78.6 | 708 | 73.9 | 558 | 24.9 | 432 | 55.5 | 81 | 9.0 | 780 | 69.1 | 1303 | 100.0 |
Deprivation
| ||||||||||||||
Q1-3 less deprived | 170 | 31.3 | 281 | 29.3 | 1075 | 48.0 | 278 | 35.7 | 315 | 35.0 | 369 | 32.7 | 492 | 37.8 |
Q4-5 more deprived | 370 | 68.1 | 675 | 70.5 | 1119 | 50.0 | 495 | 63.6 | 581 | 64.6 | 759 | 67.2 | 795 | 61.0 |
Missing | 3 | 0.6 | 2 | 0.2 | 44 | 2.0 | 5 | 0.6 | 4 | 0.4 | 1 | 0.1 | 16 | 1.2 |
Ethnic Group
| ||||||||||||||
White | 287 | 52.9 | 574 | 59.9 | 1114 | 49.8 | 616 | 79.2 | 515 | 57.2 | 670 | 59.3 | 802 | 61.6 |
Asian | 48 | 8.8 | 74 | 7.7 | 598 | 26.7 | 46 | 5.9 | 69 | 7.7 | 180 | 15.9 | 126 | 9.7 |
Black | 62 | 11.4 | 90 | 9.4 | 75 | 3.4 | 33 | 4.2 | 67 | 7.4 | 130 | 11.5 | 114 | 8.7 |
Mixed & Other | 58 | 10.7 | 104 | 10.9 | 160 | 7.1 | 47 | 6.0 | 86 | 9.6 | 102 | 9.0 | 121 | 9.3 |
Missing | 88 | 16.2 | 116 | 12.1 | 291 | 13.0 | 36 | 4.6 | 163 | 18.1 | 47 | 4.2 | 140 | 10.7 |
Comorbidity
| ||||||||||||||
No | 335 | 61.7 | 769 | 80.3 | 1177 | 52.6 | 588 | 75.6 | 720 | 80.0 | 811 | 71.8 | 1036 | 79.5 |
Yes | 208 | 38.3 | 189 | 19.7 | 1061 | 47.4 | 190 | 24.4 | 180 | 20.0 | 318 | 28.2 | 267 | 20.5 |
Procedure
| ||||||||||||||
Gastric bypass | 275 | 50.6 | ||||||||||||
Sleeve gastrectomy | 126 | 23.2 | ||||||||||||
Gastric banding | 142 | 26.2 | ||||||||||||
Emergency Readmissions
| ||||||||||||||
No | 501 | 92.3 | 903 | 94.3 | 2118 | 94.6 | 721 | 92.7 | 873 | 97 | 1053 | 93.3 | 1235 | 94.8 |
Yes | 42 | 7.7 | 55 | 5.7 | 120 | 5.4 | 57 | 7.3 | 27 | 3 | 76 | 6.7 | 68 | 5.2 |
Median
|
IQR
|
Median
|
IQR
|
Median
|
IQR
|
Median
|
IQR
|
Median
|
IQR
|
Median
|
IQR
|
Median
|
IQR
| |
Waiting time (days)
| 35 | 15-64 | 45 | 21-74 | 35 | 18-56 | 71 | 43-116 | 48 | 21-85 | 88 | 53-128 | 20 | 10-27 |
Length of stay (days)
| 2 | 1-2 | 1 | 1-2 | 1 | 1-1 | 5 | 4-7 | 1 | 1-2 | 5 | 4-7 | 4 | 1-7 |
Logistic regression
Independent Variable | Level | N | Univariate analysis | Adjusted analysis$
| ||
---|---|---|---|---|---|---|
OR (95% CI) | p-value | OR (95% CI) | p-value | |||
Age
| 18-54 | 71 (291) | Reference | |||
55-64 | 146 (540) | 1.15 (0.83- 1.59) | 0.41 | 1.13 (0.82- 1.57) | 0.47 | |
65-74 | 159 (666) | 0.97 (0.71- 1.34) | 0.86 | 0.97 (0.70- 1.34) | 0.83 | |
75+ | 89 (336) | 1.12 (0.78- 1.60) | 0.55 | 1.10 (0.76- 1.60) | 0.60 | |
Sex
| Male | 333 (1355) | Reference | |||
Female | 132 (478) | 1.17 (0.93- 1.48) | 0.19 | 1.15 (0.90- 1.46) | 0.26 | |
Ethnicity
| White | 266 (1038) | Reference | |||
Asian | 146 (574) | 0.99 (0.78- 1.25) | 0.93 | 0.87 (0.68- 1.12) | 0.27 | |
Black | 14 (71) | 0.71 (0.39- 1.30) | 0.27 | 0.58 (0.32- 1.08) | 0.08 | |
Mixed & Other | 39 (150) | 1.02 (0.69- 1.51) | 0.92 | 0.92 (0.62- 1.37) | 0.68 | |
Deprivation
| Q1-3 | 197 (867) | Reference | |||
Q4-5 | 268 (966) | 1.31 (1.06- 1.62) | 0.01 | 1.32 (1.06- 1.66) | 0.02 | |
Comorbidity
| No | 210 (924) | Reference | |||
Yes | 255 (909) | 1.33 (1.07- 1.64) | 0.01 | 1.32 (1.06- 1.64) | 0.01 |
Bariatric surgery | Cholecystectomy | Coronary angioplasty | Hip replacement | Inguinal hernia repair | Knee replacement | Mastectomy | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Age
|
aOR (95% CI)
|
Age
|
aOR (95% CI)
|
Age
|
aOR (95% CI)
|
Age
|
aOR (95% CI)
|
Age
|
aOR (95% CI)
|
Age
|
aOR (95% CI)
|
Age
|
aOR (95% CI)
| |
Waiting time
|
18-44
| 1 |
18-44
| 1 |
18-54
| 1 |
18-64
| 1 |
18-44
| 1 |
18-64
| 1 |
18-54
| 1 |
45-54
| 0.77 (0.46-1.28) |
45-54
| 1.79 (1.16-2.74)† |
55-64
| 1.13 (0.82-1.57) |
65-74
| 0.74 (0.49-1.12) |
45-54
| 0.75 (0.40-1.40) |
65-74
| 1.11 (0.80-1.55) |
55-64
| 0.65 (0.46-0.92) | |
55+
| 0.98 (0.55-1.76) |
55-64
| 1.51 (0.95-2.40) |
65-74
| 0.97 (0.70-1.34) |
75-84
| 0.70 (0.44-1.11) |
55-64
| 0.66 (0.38-1.14) |
75-84
| 1.02 (0.70-1.48) |
65-74
| 0.75 (0.50-1.11) | |
65+
| 1.57 (1.00-2.47) |
75+
| 1.10 (0.76-1.60) |
85+
| 0.71 (0.29-1.75) |
65-74
| 0.93 (0.56-1.55) |
85+
| 1.07 (0.50-2.29) |
75+
| 1.20 (0.74-1.94) | |||
75+
| 0.78 (0.45-1.34) | |||||||||||||
Length of stay
|
18-44
| 1 |
18-44
| 1 |
18-54
| 1 |
18-64
| 1 |
18-44
| 1 |
18-64
| 1 |
18-54
| 1 |
45-54
| 1.86 (1.01-3.43) |
45-54
| 1.53 (0.82-2.87) |
55-64
| 1.33 (0.85-2.09) |
65-74
| 1.09 (0.66-1.81) |
45-54
| 1.18 (0.53-2.63) |
65-74
| 1.45 (0.96-2.18) |
55-64
| 0.86 (0.60-1.24) | |
55+
| 1.32 (0.60-2.90) |
55-64
| 2.30 (1.24-4.28)† |
65-74
| 1.62 (1.05-2.49) |
75-84
| 3.43 (2.12-5.55)† |
55-64
| 1.18 (0.59-2.36) |
75-84
| 3.47 (2.29-5.24)† |
65-74
| 0.44 (0.26-0.73)† | |
65+
| 4.39 (2.51-7.67)† |
75+
| 2.08 (1.30-3.34)† |
85+
| 9.02 (4.00-20.33)† |
65-74
| 1.81 (0.96-3.44) |
85+
| 11.62 (5.76-23.47)† |
75+
| 2.37 (1.48-3.79)† | |||
75+
| 2.48 (1.30-4.73)† | |||||||||||||
Readmissions
|
18-44
| 1 |
18-44
| 1 |
18-54
| 1 |
18-64
| 1 |
18-44
|
18-64
| 1 |
18-54
| 1 | |
45-54
| 1.47 (0.71-3.04) |
45-54
| 1.43 (0.68-3.00) |
55-64
| 0.76 (0.41-1.38) |
65-74
| 1.80 (0.84-3.84) |
45-54
|
65-74
| 1.02 (0.59-1.91) |
55-64
| 1.35 (0.74-2.47) | ||
55+
| 1.00 (0.38-2.67) |
55-64
| 1.06 (0.46-2.47) |
65-74
| 0.89 (0.50-1.57) |
75-84
| 2.86 (1.34-6.07)† |
55-64
|
75-84
| 1.34 (0.72-2.49) |
65-74
| 0.68 (0.30-1.57) | ||
65+
| 1.19 (0.54-2.63) |
75+
| 0.93 (0.48-1.79) |
85+
| 8.08 (2.92-22.38)† |
65-74
|
85+
| 1.31 (0.42-4.04) |
75+
| 0.85 (0.31-2.36) |
Bariatric surgery | Cholecystectomy | Coronary angioplasty | Hip replacement | Inguinal hernia repair | Knee replacement | ||
---|---|---|---|---|---|---|---|
Waiting Time
|
Male (Reference)
| 1 | 1 | 1 | 1 | 1 | 1 |
Female
| 0.61 (0.36-1.02) | 1.38 (0.94-2.03) | 1.15 (0.90-1.46) | 1.10 (0.78-1.56) | 0.83 (0.45-1.53) | 1.13 (0.83-1.53) | |
Length of Stay
|
Male (Reference)
| 1 | 1 | 1 | 1 | 1 | 1 |
Female
| 0.81 (0.42-1.59) | 0.96 (0.61-1.50) | 1.16 (0.87-1.54) | 1.26 (0.85-1.87) | 1.36 (0.74-2.48) | 1.05 (0.75-1.47) | |
Readmissions
|
Male (Reference)
| 1 | 1 | 1 | 1 | 1 | |
Female
| 1.69 (0.63-4.50) | 1.62 (0.79-3.31) | 1.87 (1.24-2.81)† | 0.56 (0.32-1.00) | N/A | 0.82 (0.50-1.35) |
Bariatric surgery | Cholecystectomy | Coronary angioplasty | Hip replacement | Inguinal hernia repair | Knee replacement | Mastectomy | ||
---|---|---|---|---|---|---|---|---|
Waiting Time
|
White (Reference)
| 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Asian
| 1.29 (0.63-2.67) | 1.73 (1.02-2.93) | 0.87 (0.68-1.12) | 1.40 (0.73-2.68) | 1.09 (0.61-1.93) | 1.44 (0.99-2.10) | 1.50 (0.98-2.30) | |
Black
| 2.47 (1.36-4.49)† | 1.26 (0.75-2.11) | 0.58 (0.32-1.08) | 0.98 (0.44-2.18) | 0.88 (0.48-1.61) | 1.59 (1.04-2.42) | 1.33 (0.84-2.11) | |
Mixed & Other
| 0.81 (0.39-1.68) | 1.05 (0.63-1.75) | 0.92 (0.62-1.37) | 0.58 (0.26-1.27) | 1.13 (0.67-1.90) | 0.84 (0.50-1.43) | 0.71 (0.43-1.18) | |
Length of Stay
|
White (Reference)
| 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Asian
| 0.69 (0.22-2.13) | 0.62 (0.27-1.41) | 1.04 (0.76-1.41) | 0.30 (0.09-1.01) | 1.02 (0.54-1.93) | 0.97 (0.62-1.51) | 1.06 (0.65-1.74) | |
Black
| 1.38 (0.65-2.96) | 1.24 (0.62-2.47) | 1.15 (0.61-2.15) | 1.52 (0.65-3.52) | 1.24 (0.66-2.34) | 1.56 (0.99-2.47) | 1.22 (0.75-2.00) | |
Mixed & Other
| 1.87 (0.84-4.15) | 0.80 (0.39-1.64) | 1.08 (0.67-1.74) | 1.02 (0.46-2.28) | 1.09 (0.60-1.99) | 1.14 (0.66-1.99) | 1.09 (0.67-1.78) | |
Readmissions
|
White (Reference)
| 1 | 1 | 1 | 1 | 1 | 1 | |
Asian
| 1.26 (0.44-3.60) | 1.01 (0.38-2.68) | 1.00 (0.63-1.60) | 1.64 (0.55-4.92) | 0.61 (0.29-1.27) | 0.87 (0.36-2.14) | ||
Black
| 0.92 (0.33-2.58) | 0.64 (0.22-1.89) | 0.64 (0.19-2.13) | 2.22 (0.76-6.52) | 1.01 (0.51-2.00) | 1.25 (0.55-2.85) | ||
Mixed & Other
| 1.75 (0.72-4.24) | 0.88 (0.36-2.18) | 1.80 (0.98-3.33) | 1.03 (0.30-3.58) | 0.36 (0.11-1.18) | 1.09 (0.47-2.55) |
Bariatric surgery | Cholecystectomy | Coronary angioplasty | Hip replacement | Inguinal hernia repair | Knee replacement | Mastectomy | ||
---|---|---|---|---|---|---|---|---|
Waiting time
|
Q1-3 (Reference)
| 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Q4-5
| 0.76 (0.47-1.22) | 1.43 (0.98-2.10) | 1.32 (1.06-1.66) | 1.35 (0.94-1.95) | 1.47 (1.01-2.13) | 1.02 (0.74-1.39) | 0.92 (0.69-1.23) | |
Length of Stay
|
Q1-3 (Reference)
| 1 | 1 | 1 | 1 | 1 | 1 | 1 |
Q4-5
| 1.58 (0.82-3.04) | 0.65 (0.43-1.01) | 1.66 (1.25-2.20)† | 1.55 (1.02-2.34) | 1.24 (0.83-1.87) | 1.01 (0.71-1.42) | 1.37 (0.99-1.89) | |
Readmissions
|
Q1-3 (Reference)
| 1 | 1 | 1 | 1 | 1 | 1 | |
Q4-5
| 1.36 (0.62-3.01) | 1.11 (0.59-2.11) | 1.47 (0.96-2.25) | 1.42 (0.77-2.63) | 1.67 (0.94-2.95) | 1.11 (0.63-1.95) |