Emergency General Surgery and the Gallbladder: The Affordable Care Act’s Impact on Practice Patterns

Godat, Laura N; Costantini, Todd W.; Doucet, Jay

doi:10.1016/j.jss.2020.08.013

Cited by 1 publication

(1 citation statement)

References 16 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conversely, the National Reform of 2014 allowed a reduction in emergency cholecystectomies (62.1–59.3% after the reform, p <0.01), an increase in the proportion of patients treated in teaching hospitals (45.4–60.4%; p <0.01), and an increase in patients receiving Medicaid (26.3–34.0%, p <0.001) inversely proportional to the decrease in self-pay patients (19.3–13.6%, p <0.001). 30 This decrease in the proportion of self-pay patients was also observed in a cohort study on cholecystectomies performed for benign gallbladder disease. 31 In addition, there was an increase in the proportion of outpatient surgeries (80.0% vs. 78.2%, p <0.001).…”

Section: Resultsmentioning

confidence: 58%

Systematic Review: Impact of Social Determinants of Health on the Management and Prognosis of Gallstone Disease

et al. 2022

View full text Add to dashboard Cite

Background: Due to its prevalence, gallstone disease is a major public health issue. It affects diverse patient populations across various socioeconomic levels. Socioeconomic and geographic deprivation may impact both morbidity and mortality associated with digestive diseases, such as biliary tract disease. Aim: The aim of this systematic review was to review the available data on the impact of socioeconomic determinants and geographic factors on gallstone disease and its complications. Methods: This systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The MEDLINE and Web of Science databases were searched by two investigators to retrieve studies about the impact of income, insurance status, hospital status, education level, living areas, and deprivation indices on gallstone disease. Thirty-seven studies were selected for this review. Results: Socially disadvantaged populations appear to be more frequently affected by complicated or severe forms of gallstone disease. The prognosis of biliary tract disease is poor in these populations regardless of patient status, and increased morbidity and mortality were observed for acute cholangitis or subsequent cholecystectomy. Limited or delayed access and low-quality therapeutic interventions could be among the potential causes for this poor prognosis. Conclusions: This systematic review suggests that socioeconomic determinants impact the management of gallstone disease. Enhanced knowledge of these parameters could contribute to improved public health policies to manage these diseases.

show abstract

Section: Resultsmentioning

confidence: 58%