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Effect of Race and Insurance Status on Presentation, Treatment, and Mortality in Patients Undergoing Surgery for Diverticulitis—Invited Critique
Selwyn O. Rogers Jr, MD, MPH
Arch Surg. 2008;143(12):1165.
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Because US health care has focused on quality, an often-overlooked dimension is equity. Lidor et al examine the effect of race and insurance status on surgical management of diverticulitis. Using data from the Nationwide Inpatient Sample, they found that black race was associated with complicated presentation and mortality but not colostomy rates. Insurance status was a stronger predictor of surgical outcomes, as underinsurance was associated with complicated presentation, higher colostomy rates, and higher mortality.
After decades of finding associations of black race with poorer outcomes, we need to improve our understanding of the mechanisms of these disparities and design interventions to ameliorate them. Administrative databases are not designed to address underlying mechanisms. The authors noted that black patients had the same rate of colostomies as white patients, despite presenting with more complicated disease. In this case, equivalent colostomy rates may not reflect equivalent treatment. . . . [Full Text of this Article]
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Effect of Race and Insurance Status on Presentation, Treatment, and Mortality in Patients Undergoing Surgery for Diverticulitis
Anne O. Lidor, Susan L. Gearhart, Albert W. Wu, and David C. Chang
Arch Surg. 2008;143(12):1160-1165.
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