Disparities in minimally invasive surgery for colorectal cancer in Florida

• Published in: The American journal of surgery 2019-08, Vol.218 (2), p.293-301
• Main Authors: Osagiede, Osayande, Spaulding, Aaron C., Cochuyt, Jordan J., Naessens, James M., Merchea, Amit, Kasi, Pashtoon M., Crandall, Marie, Colibaseanu, Dorin T.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; African Americans; Aged; Aged, 80 and over; Cancer; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - surgery; Datasets; Ethnicity; Female; Females; Florida; Geographical locations; Government programs; Health disparities; Healthcare Disparities - statistics & numerical data; Hispanic Americans; Hospitals; Humans; Insurance; Laparoscopy; Male; Medicaid; Metastases; Metastasis; Middle Aged; Minimally invasive surgery; Minimally Invasive Surgical Procedures - statistics & numerical data; Patients; Race; Retrospective Studies; Retrospective study; Robotics; Socioeconomic factors; Surgeons; Surgery; Urbanization; Variables; Young Adult
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2018.11.019

The cost of minimally invasive surgery (MIS) raises potential for racial and social disparities. The aim of this study was to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer (CRC) in Florida. Using the Florida Inpatient Discharge Dataset, we examined the clinical data of patients who underwent elective resections for CRC during 2013–2015. Multivariable analysis was performed to identify differences in gender, age, race, urbanization, region, insurance and clinical characteristics associated with the surgical approach. Of the 10,224 patients identified, 5308 (52%) had open surgery and 4916 (48%) had MIS. Females (p = 0.012), Medicare-insured patients (p = 0.001) and residents of South Florida were more likely to undergo MIS. Patients with Medicaid (p = 0.008), metastasis (p