Race and Surgical Mortality in the United States

Lucas, F. Lee; Stukel, Thérèse A.; Morris, Arden M.; Siewers, Andrea E.; Birkmeyer, John D.

doi:10.1097/01.sla.0000197560.92456.32

Cited by 295 publications

(239 citation statements)

References 36 publications

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“…139 Moreover, these investigators have also noted that the higher operative mortality observed for black patients across a wide range of surgical procedures is due in large part to the higher mortality rates at the hospitals they attend. 140 Some investigators suggest that community-wide quality improvement initiatives may lead to improvement in care processes and outcomes. For example, a significant decrease in the combined event rate (30-day stroke or mortality) for carotid endarterectomy procedures was observed in a random sample of Medicare patients in 10 states during initial (June 1, 1995, to May 31, 1996) and subsequent (June 1, 1998, to May 31, 1999) reviews.…”

Section: Surgical Riskmentioning

confidence: 99%

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery

Fleisher¹,

Beckman²,

Brown³

et al. 2007

Circulation

622

280

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Section: Surgical Riskmentioning

confidence: 99%

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery

Fleisher¹,

Beckman²,

Brown³

et al. 2007

Circulation

622

280

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“…Equally important may be access to a surgeon with special expertise in the cancer being treated. Additionally, there are systematic differences, in the types of hospitals accessed, and such differences contribute to disparities in outcomes [16]. Patients of lower SES and minorities are more likely to access healthcare systems, institutions and primary care providers with limited resources and limited access to specialists [17].…”

Section: Differences In Getting Treatment: Access To Care and The Rolmentioning

confidence: 99%

Disparities in Oncologic Surgery

2008

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Surgical oncology is one of the most frequently studied surgical specialties with regard to disparities in quality of care. There is variation in the care received according to nonclinical factors such as age, race and ethnicity, education, income, and even geographic region. Differences exist with regard to who gets treatment, what treatment is received, and the outcomes of those treatments. Although the existence of such disparities is no longer in doubt, the etiology is still being investigated. Ongoing research and quality improvement initiatives move beyond the mere description of existing disparities in one of three ways: (1) identifying and understanding the factors that lead to disparities; (2) advancing available methods to measure and track disparities; and (3) developing an approach to improvement. In this article, we start out by offering a framework to describe potential factors that lead to disparities, using examples from surgical oncology. We then describe the approaches to measuring and tracking disparities that are being used in research and quality improvement. Finally, we attempt to illustrate how all of these factors interact and offer some potential strategies to close the gap and alleviate disparities within the discipline.Quality care of the oncology patient requires a collaborative effort among members of multiple disciplines, including surgery. For most patients with cancer, surgery plays a pivotal role, as few patients with solid tumors achieve a cure without surgical intervention. The outcomes of cancer patients have been tracked for decades through cancer registries rich in clinical and sociodemographic data. Given the integral role of surgical management in cancer outcomes and the rich data available, it is not surprising that surgical oncology is one of the most frequently studied surgical specialties with regard to disparities in quality of

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“…6,7 Recently, patient race has been identified as an important risk factor associated with surgical readmissions, [6][7][8] complications, 9 and survival among adults. 10 Within adult urology, racial disparities have been observed in outcomes for prostate cancer, 11,12 kidney cancer, 13 bladder cancer, 14,15 kidney transplantation, 16 and benign prostatic hyperplasia. 17 Black race has also been associated with adverse outcomes in pediatric patients undergoing general surgery, 18 cardiac surgery, 19 and otolaryngologic procedures.…”

mentioning

confidence: 99%