TBA (25W134)

Impact of Social Deprivation on Liver Disease Admissions – An In-depth Analysis of a Large Urban Hospital

Author(s)

Foley C (1), Noone D (2), Keegan M (3), Russell J (1), Stewart S (1), Ryan JD (2);

Department(s)/Institutions

1. Liver Centre, Mater Misericordiae University Hospital, Dublin, Ireland 2. Hepatology Unit, Beaumont Hospital, Dublin, Ireland 3. Pobal, Holbrook House, Holles Street, Dublin, Ireland

Introduction

Social deprivation has been linked to poor outcomes in liver disease. This has not been assessed in Ireland.

Aims/Background

To review all liver admissions in Beaumont Hospital according to patient specific social deprivation scores.

Method

Hospital In-Patient Enquiry (HIPE) inpatient admission data was reviewed from 1/1/2017 to 12/12/2023. Social deprivation scores were assigned via collaboration with Pobal. The total population within each deprivation score of the hospital catchment area was established to determine admissions per 100,000 population. Median length of stay and in-hospital mortality rates were also assessed according to deprivation score.

Results

There were a total of 851 liver disease admissions of which 58.6% were alcohol related. While only 37% of the catchment area population resided in below average or more deprived areas, these areas accounted for 60.2% of admissions. Admission risk rose significantly with deprivation score; Affluent 87/100,000, Marginally above average 151/100,000, Marginally below average 331/100,000, Disadvantaged 293/100,000, Very Disadvantaged 415/100,000, Extremely Disadvantaged 207/100,000. Affluent admissions were significantly lower compared to disadvantaged, very disadvantaged and extremely disadvantaged admissions (p= 0.006, p= 0.0227, p= 0.0023). No significant difference was observed in relation to median lengths of stay (LOS) and mortality rates according to deprivation score. Patients from disadvantaged or more deprived areas occupied more ICU bed days compared to patients from affluent areas (p=0.0044).

Conclusions

Social deprivation increases risk of admission with liver disease to hospital and ICU. Once admitted, however, length of stay and mortality are the same regardless of social deprivation group.