A. Talukder1, P. Martinez1, J. McKenzie1, R. Lassiter1, C. White1, D. Albo1 1Medical College Of Georgia,Department Of Surgery,Augusta, GA, USA
Introduction: Studies have demonstrated favorable outcomes for laparoscopic surgery over open surgery in the treatment of a variety of surgical diseases. In this study we analyzed regional differences in the use of laparoscopic surgery with respect to race in academic and non-academic centers in all geographic regions of the US, comparing to them our home state and our region.
Methods: A retrospective analysis of elective admissions with a primary diagnosis of diverticulitis from 2009-12 was performed using data from the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Cases were selected based on diagnosis codes of Diverticulitis of colon with or without mention of hemorrhage and (ICD9 56.11, 562.13). All patients underwent a surgery as defined by non-endoscopic ICD-9-CM procedure codes for colorectal resection.
Results: At academic centers in the US, laparoscopic utilization rate was 44.5% for Whites, 29.5% for Blacks, and 39.4% for Hispanics and 38.2%, 29.6%, 38.0% respectively at non-academic centers. Odds of laparoscopic resection for Whites when compared to Blacks was 1.57 higher (95% CI: 1.45-1.71, p <0.01). At academic centers in the Southeast, the laparoscopic utilization rate was 44% for Whites, 35% for Blacks, and 60.1% at Hispanics academic centers, and 36.7%, 29%, and 57.9% respectively at non-academic centers. Odds of laparoscopic resection for Whites compared to Blacks was 1.45 higher (95% CI: 1.23-1.72, p <0.01). In academic centers in GA, the laparoscopic utilization rate was 48.9% for Whites, 21.4% for Blacks, and 0% for Hispanics and 47.5%, 47.9%, and 28.6% respectively at non-academic centers. Odds of laparoscopic resection for Whites compared to Blacks was 1.65 higher (95% CI: 1.93 – 3.20, p < 0.05). We have completed this analysis for all the Northeast, Mideast, Great Lakes, Plains, Southwest, Rocky Mountain, and Far West regions as well.
Conclusion: These results demonstrate significant disparities in the use of laparoscopic surgery to treat diverticulitis both at academic and non-academic centers at the national, regional, and state level.
