Impact of neighborhood characteristics on textbook outcome following major surgery

Background: The aim of the current study was to determine the impact of neighborhood characteristics on textbook outcome (TO) following surgery. Methods: Medicare beneficiaries undergoing AAA repair, CABG, colectomy, or lung resection. Neighborhood characteristics associated with TO were identified. Results: Among 852,128 Medicare beneficiaries, a 10% increase in the mean percentage of college or advanced degree residents (OR:1.04, 95% CI = 1.04-1.05) was associated with 4% greater odds of a TO, whereas 2% lower odds of TO were noted with a 10% increase in the mean percentage of single-parent households (OR: 0.98, 95% CI = 0.97-0.99). Of note, the highest odds of an extended LOS (OR:1.06, 95% CI: 1.05-1.06) and 90-d mortality (OR: 1.05, 95% CI: 1.04-1.06) were observed with single-parent households. Conclusions: Among patients undergoing a range of common surgical procedures, increases in college or advanced degrees residents and a decrease in single-parent households led to significantly higher odds of achieving a TO.