Non-Hispanic Blacks undergoing distal pancreatectomy have higher risk-adjusted rates of morbidity and are more likely to be high-cost outliers |
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| Authors: | Emanuel Eguia Joseph N Fahmy Adrienne N Cobb Patrick Sweigert Gerard V Aranha Gerard Abood Paul C Kuo Marshall S Baker |
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| Institution: | 1. Department of Surgery, Loyola University Medical Center, Maywood, IL, USA;2. Department of Surgery, University of South Florida, Tampa, FL, USA;1. Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE;2. Department of Radiation Medicine, Oregon Health and Science University, Portland, OR;3. Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, MD;1. Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL;2. Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN;3. Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL;4. Barry University, Miami, FL |
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| Abstract: | BackgroundFew studies evaluate racial disparities in costs and clinical outcomes for patients undergoing distal pancreatectomy (DP).MethodsWe queried the Healthcare Cost and Utilization Project State Inpatient Databases to identify patients undergoing DP. Multivariable regression (MVR) was used to evaluate the association between race and postoperative outcomes.Results2,493 patients underwent DP; 265 (10%) were black, and 221 (8%) were of Hispanic ethnicity. On MVR, black and Hispanic patients were less likely than whites to undergo surgery in high volume centers (OR 0.53, 95% CI 0.40, 0.71]; OR 0.45, 95% CI 0.32, 0.62]). Black patients had a greater risk of postoperative complication (OR 1.40, 95% CI 1.07, 1.83]), 90-day readmission (OR 1.53, 95% CI 1.15, 2.02]), prolonged length of stay (OR 1.74, 95% CI 1.25–2.44]), and of being a high cost outliers (OR 1.40, 95% CI 1.02, 1.91]) compared to white patients.ConclusionBlack patients have increased risk of having a postoperative complication, prolonged hospitalization, and of being a high-cost outlier than non-Hispanic whites. |
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| Keywords: | Distal pancreatectomy Oncology Social determinants of health Healthcare utilization |
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