Abstract
While socioeconomic status (SES) and migration background have been linked to complicated lower respiratory tract infections (LRTIs) in population-based studies, their predictive value in primary care remains unclear. Using routine care data from Dutch general practices (Leiden-The Hague-Zoetermeer region, n ≈ 750,000 adult patients, 2014 to 2023, excluding COVID-19 years), linked to sociodemographic and hospital claims data, we developed a multivariable logistic regression model to predict 30-day hospitalisation or death following LRTI. Among 186,094 LRTI episodes, 2.19% were classified as complicated. After adjusting for established clinical factors, SES was a strong predictor, whereas migration background was not. Patients in the lowest SES category had an adjusted odds ratio of 1.46 (95%CI: 1.31 – 1.62) for a complicated course compared to the highest. The incorporation of SES into clinical decision tools and guidelines has the potential to enhance risk-stratification of patients with LRTI in daily practice of primary care, thereby supporting more equitable care.
Competing Interest Statement
The authors have declared no competing interest.
Funding Statement
The study was not funded by a specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Author Declarations
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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:
The appropriate approval that the study was not subject to the Medical Examination Act was granted by the Medical Ethical Committee of the Leiden University Medical Center (LUMC) under reference number 25-3023.
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