TY - JOUR
T1 - Disparities in the use of minimally invasive surgery for colorectal disease
AU - Robinson, Celia N.
AU - Balentine, Courtney J.
AU - Sansgiry, Shubhada
AU - Berger, David H.
N1 - Funding Information:
This study was supported by the Houston VA Health Services Research & Development Center of Excellence (HFP90-020). Dr. Robinson is also supported by the Baylor College of Medicine Comprehensive Cancer Training Program Grant (CPRIT RP 101499). The views expressed in this article are those of the author(s) and do not necessarily represent the views of the Department of Veterans Affairs. C.N.Robinson.C.J.Balentine.D.H.Berger(*) Operative Care Line, The Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd. 5A 350, Mailing code OCL 112, Houston, TX 77030, USA e-mail: Dhb@bcm.edu
PY - 2012/5
Y1 - 2012/5
N2 - Background Morbidity and mortality rates for major surgical procedures are decreased in high-volume hospitals (HVH). Additionally, HVH are often leaders in the utilization of novel surgical technology such as minimally invasive surgery (MIS). Although HVH often serve diverse patient populations, it is unknown if there are disparities in the application of new surgical technologies within these hospitals. We sought to determine if ethnic and socioeconomic disparities in the use of MIS for colorectal disease exist at HVH. Methods Laparoscopic and open colectomies performed at HVH were identified using the 2008 Nationwide Inpatient Sample database. ICD-9 codes were used to identify MIS colorectal resections. Multiple logistic regression including ethnic and socioeconomic variables were used to identify independent predictive factors for undergoing MIS. Results A total of 211,862 colorectal resections were performed at HVH in 2008. Only 16,637 (7.3%) colorectal resections were performed using MIS. When evaluating racial and socioeconomic factors, patients within the highest income quartile were more likely to undergo MIS than those in the lowest income groups. In addition, patients with Medicaid and uninsured patients were significantly less likely to undergo MIS compared to patients with private insurance. Lastly, race was not a significant predictive factor for undergoing MIS for colorectal disease at HVH. Conclusion There are significant socioeconomic disparities in the use of MIS for colorectal disease at HVH. Future studies should be aimed at identifying access barriers to MIS in the treatment of colorectal disease.
AB - Background Morbidity and mortality rates for major surgical procedures are decreased in high-volume hospitals (HVH). Additionally, HVH are often leaders in the utilization of novel surgical technology such as minimally invasive surgery (MIS). Although HVH often serve diverse patient populations, it is unknown if there are disparities in the application of new surgical technologies within these hospitals. We sought to determine if ethnic and socioeconomic disparities in the use of MIS for colorectal disease exist at HVH. Methods Laparoscopic and open colectomies performed at HVH were identified using the 2008 Nationwide Inpatient Sample database. ICD-9 codes were used to identify MIS colorectal resections. Multiple logistic regression including ethnic and socioeconomic variables were used to identify independent predictive factors for undergoing MIS. Results A total of 211,862 colorectal resections were performed at HVH in 2008. Only 16,637 (7.3%) colorectal resections were performed using MIS. When evaluating racial and socioeconomic factors, patients within the highest income quartile were more likely to undergo MIS than those in the lowest income groups. In addition, patients with Medicaid and uninsured patients were significantly less likely to undergo MIS compared to patients with private insurance. Lastly, race was not a significant predictive factor for undergoing MIS for colorectal disease at HVH. Conclusion There are significant socioeconomic disparities in the use of MIS for colorectal disease at HVH. Future studies should be aimed at identifying access barriers to MIS in the treatment of colorectal disease.
KW - Colorectal disease
KW - Healthcare disparities
KW - Minimally invasive surgery
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U2 - 10.1007/s11605-012-1844-3
DO - 10.1007/s11605-012-1844-3
M3 - Article
C2 - 22411487
AN - SCOPUS:84865322670
SN - 1091-255X
VL - 16
SP - 897
EP - 904
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 5
ER -