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Understanding Racial and Ethnic Disparities in Postsurgical Complications Occurring in U.S. Hospitals.


ABSTRACT:

Objective

To examine the role of patient, hospital, and community characteristics on racial and ethnic disparities in in-hospital postsurgical complications.

Data sources

Healthcare Cost and Utilization Project, 2011 State Inpatient Databases; American Hospital Association Annual Survey of Hospitals; Area Health Resources Files; Centers for Medicare & Medicaid Services Hospital Compare database.

Methods

Nonlinear hierarchical modeling was conducted to examine the odds of patients experiencing any in-hospital postsurgical complication, as defined by Agency for Healthcare Research and Quality Patient Safety Indicators.

Principal findings

A total of 5,474,067 inpatient surgical discharges were assessed using multivariable logistic regression. Clinical risk, payer coverage, and community-level characteristics (especially income) completely attenuated the effect of race on the odds of postsurgical complications. Patients without private insurance were 30 to 50 percent more likely to have a complication; patients from low-income communities were nearly 12 percent more likely to experience a complication. Private, not-for-profit hospitals in small metropolitan or micropolitan areas and higher nurse-to-patient ratios led to fewer postsurgical complications.

Conclusions

Race does not appear to be an important determinant of in-hospital postsurgical complications, but insurance and community characteristics have an effect. A population-based approach that includes improving the socioeconomic context may help reduce disparities in these outcomes.

SUBMITTER: Witt WP 

PROVIDER: S-EPMC5264108 | biostudies-literature | 2017 Feb

REPOSITORIES: biostudies-literature

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Publications

Understanding Racial and Ethnic Disparities in Postsurgical Complications Occurring in U.S. Hospitals.

Witt Whitney P WP   Coffey Rosanna M RM   Lopez-Gonzalez Lorena L   Barrett Marguerite L ML   Moore Brian J BJ   Andrews Roxanne M RM   Washington Raynard E RE  

Health services research 20160309 1


<h4>Objective</h4>To examine the role of patient, hospital, and community characteristics on racial and ethnic disparities in in-hospital postsurgical complications.<h4>Data sources</h4>Healthcare Cost and Utilization Project, 2011 State Inpatient Databases; American Hospital Association Annual Survey of Hospitals; Area Health Resources Files; Centers for Medicare & Medicaid Services Hospital Compare database.<h4>Methods</h4>Nonlinear hierarchical modeling was conducted to examine the odds of pa  ...[more]

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