Outcomes in the Utilization of Single Percutaneous Cholecystostomy in a Low-Income Population
Ping Lu1,2, Nan-Ping Yang3,4, Nien-Tzu Chang5
1School of Economics and Management, Xiamen University of Technology, Xiamen 361024, China. luping@xmut.edu.cn.
Insights
Low-income populations undergoing percutaneous cholecystostomy (PC) have higher in-hospital mortality but lower recurrence rates. Socioeconomic status significantly impacts PC outcomes, suggesting careful consideration of financial situations for these patients.
Area of Science:
- Medical procedures
- Socioeconomic impacts on health
- Health disparities
Background:
- Percutaneous cholecystostomy (PC) is a common procedure for gallbladder issues.
- Limited research exists on PC outcomes specifically within low-income populations (LIPs).
- Understanding health disparities in surgical outcomes is crucial for equitable healthcare.
Purpose of the Study:
- To compare the outcomes of percutaneous cholecystostomy (PC) between low-income populations (LIPs) and the general population (GP).
- To investigate the influence of socioeconomic status on PC procedure success and patient prognosis.
- To identify specific risks and benefits associated with PC in LIPs.
Main Methods:
- Retrospective analysis of 11,184 patients who underwent PC between 2003 and 2012.
- Data sourced from Taiwan's National Health Insurance Research Database.
- Propensity score matching (1:5 ratio) was used to compare LIP and GP cohorts.
Main Results:
- LIPs had a 64% higher crude rate of single PC compared to the GP.
- In-hospital mortality was significantly higher in the LIP group post-matching.
- One-year recurrence rates were lower in LIPs, while 30-day mortality and complication rates were higher, though not always significantly.
Conclusions:
- Low-income populations undergoing PC face poorer prognoses compared to the general population.
- Socioeconomic status is an adverse prognostic factor for percutaneous cholecystostomy outcomes.
- Surgeons should consider patients' financial status and potential post-surgical challenges for LIPs.
Abstract:
Numerous studies have investigated the applicable populations for percutaneous cholecystostomy (PC) procedures, but the outcomes of PC in low-income populations (LIPs) have been insufficiently studied. Data for 11,184 patients who underwent PC were collected from the National Health Insurance Research Database of Taiwan during 2003 and 2012. The overall crude rate of single PC for the LIP was 64% higher than that for the general population (GP). After propensity score matching for the LIP and GP at a ratio of 1:5, the outcome analysis of patients who underwent PC showed that in-hospital mortality was significantly higher in the LIP group than in the GP group, but one-year recurrence was lower. The rates of 30-day mortality and in-hospital complications were higher for the LIP patients than for the GP patients, and the rate of routine discharge was lower, but the differences were not significant. In conclusion, LIP patients undergoing PC exhibit poor prognoses relative to GP patients, indicating that a low socioeconomic status has an adverse impact on the outcome of PC. We suggest that surgeons fully consider the patient's financial situation during the operation and further consider the possible poor post-surgical outcomes for LIP patients.
