Abstract | November 17, 2023

Educational Attainment and Acute Kidney Stone Surgical Delay

Caroline Baughn, MS-4, University of Central Florida, College of Medicine, Orlando, FL

Sudarshan Srirangapatanam, MS-4, University of Central Florida, College of Medicine, Orlando, FL; Avaneesh Kunta, MS-2, University of Central Florida, College of Medicine, Orlando, FL; Ayssel Tanbari, MS-4, University of Central Florida, College of Medicine, Orlando, FL; Hubert Swana, MD, Orlando Health/Arnold Palmer Hospital, Orlando, Florida

Learning Objectives

  1. To discuss the role of educational attainment as a measure of health literacy, and to examine the effect of educational attainment on surgical delay for kidney stone procedure in the acute setting.

Background:
Low socioeconomic status (SES) is known to contribute to kidney stone surgical delay, however the impact of educational attainment level has not been specifically studied. Patient-centered education has been shown to decrease surgical delay across many specialties, though guidelines to determine the type of education with regard to a patients’ health literacy level are scare. Low healthy literacy has been implicated in numerous surgical complications. We analyzed levels of educational attainment and surgical delay times for kidney stone procedures in the acute setting.

Methods:
De-identified patient data from 2016-2020, within Florida, from Healthcare Cost and Utilization Project (HCUP) dataset, was analyzed. Patient-level surgical delay (median time to surgery in days) was then aggregated by ZCTAs. Educational attainment (1. High school degree or less, 2. College graduate, or 3. Professional degree) from Agency for Healthcare Research and Quality’s (AHRQ) dataset was merged to complete the data set. Linear regression was performed to study trends in surgical delay, using R version 4.

Results: 7,401 patients were identified within the 304 Florida ZCTAs. Those with a high school degree or less experienced a significant increase in surgical delay (slope = 2.74, p<0.001). Those with a college or professional degree had a decrease in surgical delay (slope = -1.04 and -1.70, respectively, p<0.05).

Conclusion: Educational attainment may serve as an easily measurable proxy for health literacy. In this study, education attainment level was found to impact kidney stone surgical delay. Patients with lower educational attainment were at an increased risk for surgical delay, and thus, possibly worse outcomes. Further studies examining the role of educational attainment and health literacy on surgical delays and outcomes are merited. Deeper investigation has the potential to formulate standardized guidelines to improve patient surgical timelines and outcomes.

References and References

  1. De Oliveira GS Jr, McCarthy RJ, Wolf MS, Holl J. The impact of health literacy in the care of surgical patients: a qualitative systematic review. BMC Surg. 2015;15:86. Published 2015 Jul 17. doi:10.1186/s12893-015-0073-6
  2. Berkman ND, Sheridan SL, Donahue KE, Halpern DJ, Crotty K. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97-107. doi:10.7326/0003-4819-155-2-201107190-00005
Posted in: Surgery & Surgical Specialties67
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