Evidence mapPaperPMID 39647192Full record

ArticleThe Journal of surgical research2025

Housing Instability and Outcomes Among Patients With Access-Sensitive Surgical Conditions.

Emily E Evans, Nicholas Kunnath, Esther J Oh, John W Scott, Megan Janeway

Abstract read
In one paragraph

Article in The Journal of surgical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

5 authors.

Emily E EvansUniversity of Michigan Medical School, Ann Arbor, Michigan. Electronic address: emeevans@med.umich.edu.
Nicholas KunnathCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan.
Esther J OhCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan.
John W ScottCenter for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan; Department of Surgery, University of Michigan, Ann Arbor, Michigan.
Megan JanewayDepartment of Surgery, University of Michigan, Ann Arbor, Michigan.

Funding

Insurance Coverage and Workforce Incentives to Improve Access to Surgical CareR01DK137466 · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2025 to 2025
$376k
AHRQ HHS K08 HS028672NIDDK NIH HHS R01 DK137466
6 · The paper itself

Abstract

introductionHousing instability is a significant contributor to poor health but remains understudied among surgical patients. We evaluated the association between housing instability and rates of unplanned surgical procedures, as well as resultant health and financial outcomes, for patients with access-sensitive conditions.

methodsUsing the Healthcare Cost and Utilization Project National Inpatient Sample, we identified patients who underwent one of four selected procedures for access-sensitive surgical conditions (abdominal aortic aneurysm repair, colectomy, incisional hernia repair, and lower extremity bypass). Housing status was determined using International Classification of Disease, 10th Revision, Clinical Modification codes Z59.0 (homelessness) and Z59.1 (lack of adequate housing). Risk-adjusted multivariable logistic regression compared outcomes between patients with and without housing instability.

resultsOf 1,761,965 individuals admitted for access-sensitive surgical conditions, 2280 were experiencing housing instability. Housing-unstable individuals had more than four times the odds of undergoing unplanned surgery than housing-stable individuals (odds ratio 4.41, P < 0.001). Across all procedures, individuals with housing instability experienced longer lengths of stay (planned: 5 d versus 4 d, P < 0.001; unplanned: 8 d versus 7 d, P < 0.001) and higher costs per admission following planned surgery ($20,379 versus $18,152, P < 0.001) than housing-stable individuals. Housing-unstable individuals had lower odds of complications and in-hospital mortality following planned surgeries. No differences in morbidity or mortality were identified following unplanned surgeries.

conclusionsPatients experiencing housing instability had higher odds of undergoing unplanned surgical procedures, had longer hospital stays and higher costs, and had similar or better outcomes following surgery. Efforts to expand affordable housing opportunities may improve access to timely surgical care.

Indexed as

Health Services AccessibilityHousingSurgical Procedures, OperativeAdultAgedFemaleHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesUnited StatesAccess-sensitive surgical conditionsAccess to careEmergency surgeryHealth servicesHomelessnessHouselessnessHousing instabilityIll-housed persons

Identifiers

PMID39647192
PMCPMC13218821

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.