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Although numerous epidemiological studies on cholecystectomy have been conducted worldwide, only a few have considered the effect of socioeconomic inequalities on cholecystectomy outcomes. Specifically, few studies have focused on the low-income population LIP. A nationwide prospective study based on the Taiwan National Health Insurance dataset was conducted during — Temporal trends were analyzed using a joinpoint regression, and the hierarchical linear modeling HLM method was used as an analytical strategy to evaluate the group-level and individual-level factors.

Analyses were conducted on , patients. The incidence rates were After cholecystectomy, LIP patients showed higher rates of day mortality, in-hospital complications, and readmission for complications, but a lower rate of routine discharge than GP patients. The multilevel analysis using HLM revealed that adverse socioeconomic status significantly negatively affects the outcomes of patients undergoing cholecystectomy. Additionally, male sex, advanced age, and high Charlson Comorbidity Index CCI scores were associated with higher rates of in-hospital complications and day mortality.

We also observed that the day mortality rates for patients who underwent cholecystectomy in regional hospitals and district hospitals were significantly higher than those of patients receiving care in a medical center. Patients with a disadvantaged finance status appeared to be more vulnerable to cholecystectomy surgery. This result suggested that further interventions in the health care system are necessary to reduce this disparity. Gallbladder disease remains one of the most common problems encountered in surgical intervention and, if managed incorrectly, can lead to high rates of morbidity and mortality [ 1 ].

Approximately 20 million people in the USA have gallstones, leading to over one million hospitalizations and , operative procedures annually [ 2 , 3 ]. The overall prevalence of gallstone disease is 5.