This US study retrospectively assessed associations between neighbourhood area deprivation index (ADI) and 30-day rehospitalisation for a random 5% national sample of 255,744 Medicare patients discharged with congestive heart failure, pneumonia, or myocardial infarction between 2004 and 2009. In multivariate logistic regression models adjusted for patient sociodemographic characteristics, comorbid conditions and severity, and index hospital characteristics, 30-day rehospitalisation rates did not vary significantly across the least disadvantaged 85% of neighbourhoods, which had an average rehospitalisation rate of 21%. In contrast, Medicare patients living within the most disadvantaged 15% of neighbourhoods were readmitted to hospital within 30 days at rates ranging from 22% to 27% with worsening ADI. This relationship persisted after full adjustment, with residence within the most disadvantaged neighbourhoods predicting a risk of rehospitalisation (adjusted risk ratio 1.09; 95% CI, 1.05 to 1.12) of similar magnitude to that of chronic pulmonary disease (1.06; 1.04 to 1.08) and greater than that of uncomplicated diabetes (0.95; 0.94 to 0.97).
