Racial Disparities in 30-Day Outcomes After Colorectal Surgery in an Integrated Healthcare System

Background Racial disparities in colorectal surgery outcomes have been studied extensively in the USA, and access to healthcare resources may contribute to these differences. The Veterans Health Administration (VHA) is the largest integrated healthcare network in the USA with the potential for equal...

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Bibliographic Details
Published in:Journal of gastrointestinal surgery 2022-02, Vol.26 (2), p.433-443
Main Authors: Holleran, Timothy J., Napolitano, Michael A., LaPiano, Jessica B., Arnott, Suzanne, Amdur, Richard L., Brody, Fredrick J., Duncan, James E.
Format: Article
Language:English
Subjects:
Colorectal Surgery
Delivery of Health Care, Integrated
Ethnicity
Gastroenterology
Healthcare Disparities
Humans
Inequality
Medicine
Medicine & Public Health
Original Article
Race
Racial differences
Retrospective Studies
Surgery
United States - epidemiology
Veterans
White People
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Summary:Background Racial disparities in colorectal surgery outcomes have been studied extensively in the USA, and access to healthcare resources may contribute to these differences. The Veterans Health Administration (VHA) is the largest integrated healthcare network in the USA with the potential for equal access care to veterans. The objective of this study is to evaluate the VHA for the presence of racial disparities in 30-day outcomes of patients that underwent colorectal resection. Methods Colon and rectal resections from 2008 to 2019 were reviewed retrospectively using the Veterans Affairs Surgical Quality Improvement Program database. Patients were categorized by race and ethnicity. Multivariable analysis was used to compare 30-day outcomes. Cases with “unknown/other/declined to answer” race/ethnicity were excluded. Results Thirty-six-thousand-nine-hundred-sixty-nine cases met inclusion criteria: 27,907 (75.5%) Caucasian, 6718 (18.2%) African American, 2047 (5.5%) Hispanic, and 290 (0.8%) Native American patients. There were no statistically significant differences in overall complication incidence or mortality between all cohorts. Compared to Caucasian race, African American patients had longer mean length of stay (10.7 days vs. 9.7 days; p 
ISSN:1091-255X
1873-4626
DOI:10.1007/s11605-021-05151-6