Disparities in elective surgery for diverticulitis: Identifying the gap in care - 17/10/19
Abstract |
Background |
Minimally invasive surgery (MIS) in patients with diverticulitis is advantageous relative to open surgery. We aimed to determine disparities associated with MIS access for diverticulitis and post-operative complications.
Methods |
The Florida Inpatient Discharge Dataset was retrospectively queried for patients with diverticulitis undergoing elective surgery between 2013 and 2015. Associations of patient, physician, and hospital characteristics with surgical approach (MIS vs open) and development of complications were calculated in two separate mixed effects logistic regression models.
Results |
Of the 5857 patients in the analysis, older, sicker patients, residing in rural areas or with Medicaid insurance had decreased odds of receiving MIS. Being treated by high volume or colorectal surgeons increased the odds of MIS. Decreased complications were present with MIS, in younger, healthier patients, treated by high volume surgeons.
Conclusions |
Disparities in Florida are present in patients undergoing elective diverticulitis surgery. MIS access and complications rates are not equal, and MIS is associated with significantly reduced odds of post-operative complications. Improved access to MIS-trained surgeons is a critical step towards improving surgical outcomes for Floridians.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Disparities are present for patients undergoing elective surgery for diverticulitis in Florida. |
• | Complication rate and access to minimally invasive surgery are not the same for all patients. |
• | MIS is the optimal treatment for diverticulitis requiring elective surgery. |
• | High surgeon volume and MIS-training were predictors for lower complication rate. |
Keywords : Colorectal surgery, Disparities, Minimally invasive surgery, Complications, Diverticulitis
Plan
Vol 218 - N° 5
P. 899-906 - novembre 2019 Retour au numéro
Article précédent
- Safety evaluation of simultaneous resection of colorectal primary tumor and liver metastasis after neoadjuvant therapy: A propensity score matching analysis
- Yuchen Wu, Fangqi Liu, Wang Song, Fei Liang, Lu Wang, Ye Xu
- Incidence of and risk factors for delayed acute kidney injury in patients undergoing colorectal surgery
- Youn Kyung Kee, Hyoungnae Kim, Jong Hyun Jhee, Seung Hyeok Han, Tae-Hyun Yoo, Shin-Wook Kang, Jung Tak Park
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?