Racial disparities in access and outcomes of cholecystectomy in the United States

John V. Gahagan, Mark H. Hanna, Matthew D. Whealon, Steven Maximus, Michael J. Phelan, Michael Lekawa, Cristobal Barrios, Nicole P. Bernal

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Disparities in access to health care between white and minority patients are well described. We aimed to analyze the trends and outcomes of cholecystectomy based on racial classification. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy from 2009 to 2012. Patients were stratified as white or non-white. A total of 243, 536 patients were analyzed: 159, 901 white and 83, 635 non-white. Non-white patients had significantly higher proportions of Medicaid (25% vs 9.3%), self-pay (14% vs 7.1%), and no-charge (1.8% vs 0.64%). Nonwhite patients had significantly higher rates of emergent admission (84% vs 78%) compared with the white patients. Multivariate analysis revealed that non-whites had a significantly longer length of stay [mean difference of 0.14 days, 95% confidence interval (CI) 0.08-0.20] and higher total hospital charges (mean difference of $6748.00, 95% CI 5994.19-7501.81) than whites, despite a lower morbidity (odds ratio 0.94, 95% CI 0.90-0.98). Use of laparoscopy and mortality were not different. These differences persisted on subgroup analysis by insurance type. These findings suggest a gap in access to and outcomes of cholecystectomy in the minority population nationwide.

Original languageEnglish (US)
Pages (from-to)921-925
Number of pages5
JournalAmerican Surgeon
Volume82
Issue number10
StatePublished - Oct 2016
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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