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Published on: August 1, 2019
Community-based health preferences for proctocolectomy: a race comparison
Geoffrey C Nguyen1, Anne Tuskey, Theodore M Bayless
1Harvey M. and Lyn P. Meyerhoff Inflammatory Bowel Disease Center, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. gnguyen@jhmi.edu
Racial differences in surgical preferences are not a major cause of disparities in proctocolectomy rates between African Americans and whites. Patient health utility ratings for ileal pouch anal anastomosis and ileostomy were similar across racial groups.
Area of Science:
- Colorectal surgery
- Health disparities research
- Patient-reported outcomes
Background:
- Significant racial disparities exist in proctocolectomy utilization.
- Understanding the drivers of these disparities is crucial for equitable healthcare.
- Patient preferences for surgical options may contribute to utilization differences.
Purpose of the Study:
- To investigate whether racial differences in patient preferences for surgery explain disparities in proctocolectomy utilization.
- To compare health preferences for ileal pouch anal anastomosis (IPAA) and ileostomy between African Americans (AA) and whites.
Main Methods:
- Employed the time trade-off technique to assess health preferences.
- Recruited a community sample of 23 white and 16 AA participants without colorectal disease.
- Measured health utility ratings for IPAA and ileostomy.
Main Results:
- African Americans and whites exhibited similar baseline quality of life and comorbidity profiles.
- No significant differences were observed in health utility ratings for IPAA between AA and whites (P = 0.95).
- Health preference ratings for ileostomy were also comparable between AA and white participants.
Conclusions:
- Patient preferences for proctocolectomy surgical options are unlikely to be a primary driver of racial disparities in utilization.
- Further research is needed to identify other factors contributing to observed racial differences in proctocolectomy rates.
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