Background: Area Deprivation Index (ADI) and Social Vulnerability Index (SVI) are neighborhood-level measures of social determinants of health. This study compares individual-level Z codes with these neighborhood-level measures through spatial analysis and their associations with postoperative morbidity.
Methods: This retrospective cohort study included patients at an urban hospital between 2015 and 2021. Spatial autocorrelation was assessed using Global Moran's I. A multivariable logistic regression model assessed their association with 30-day postoperative morbidity.
Results: There was no spatial autocorrelation for Z codes (Moran's I: 0.001, p = .96), but there was for ADI (Moran's I:0.013, p < .001) and SVI (Moran's I:0.007, p < .001). Z codes were associated with 90 % increased odds of morbidity [CI:1.39-2.58]. For every one-point increase in ADI, odds of morbidity increased by 7 % [CI:1.04-1.11], but SVI was not associated.
Conclusions: Both individual- and neighborhood-level factors were associated with increased postoperative morbidity. However, Z codes demonstrate greater predictive value than neighborhood-level measures.
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