Understanding Racial and Ethnic Disparities in Postsurgical Complications Occurring in U.S. Hospitals
Whitney P Witt1, Rosanna M Coffey2, Lorena Lopez-Gonzalez3
1Maternal and Child Health Research, Truven Health Analytics, Inc., 4819 Emperor Boulevard, Suite 125, Durham, NC 27703.
Health Services Research
|March 13, 2016
Summary
Racial disparities in postsurgical complications are not driven by race itself, but by socioeconomic factors like insurance and community income. Addressing these social determinants can reduce healthcare outcome gaps.
Area of Science:
- Health Services Research
- Health Disparities
- Surgical Outcomes
Background:
- Racial and ethnic disparities persist in healthcare, particularly concerning postsurgical complications.
- Understanding the interplay of patient, hospital, and community factors is crucial for addressing these disparities.
Purpose of the Study:
- To investigate the influence of patient, hospital, and community characteristics on racial and ethnic disparities in in-hospital postsurgical complications.
Main Methods:
- Utilized nonlinear hierarchical modeling on a large dataset (5,474,067 inpatient surgical discharges) from multiple databases.
- Employed multivariable logistic regression to analyze the odds of postsurgical complications.
Main Results:
- Clinical risk, insurance status, and community income significantly impacted postsurgical complication rates, fully explaining the effect of race.
- Lack of private insurance increased complication odds by 30-50%; low community income increased odds by nearly 12%.
Conclusions:
- Race is not a primary determinant of postsurgical complications; socioeconomic factors are key.
- A population-based strategy focusing on socioeconomic context is essential to reduce outcome disparities.
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