Considerable racial disparities in surgical outcomes exist even in institutions that have sought to avoid race-based variation in outcomes by enrolling in quality improvement initiatives, according to an Annals of Surgery study.
"Given that the [American College of Surgeons' National Surgical Quality Improvement Program] is comprised of institutions that emphasize quality-of-care improvement — most of them large academic centers — we thought outcomes for black and other ethnic groups would be similar to those experienced by white patients. That's not what we found," Akshay Sood, MD, of Henry Ford's Vattikuti Urology Institute and lead author of the study, said in a statement.
Researchers from the Henry Ford Health System in Detroit pulled data from the ACS-NSQIP on more than 142,000 patients. Each patient had undergone one of 16 major surgeries between 2005 and 2011. Their findings call into question prior studies that have suggested a reduction in race-based outcomes in healthcare in the U.S.
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Among the patients, 85 percent were white, 8 percent were black, 4 percent were Hispanic and less than 3 percent were Asian or a different race. Black patients had a greater chance of requiring a prolonged hospital stay after receiving 10 of the 16 surgeries, although by this metric there was no disparity in mortality rates within 30 days of the procedure.
Although the Hispanic group had fewer disparities than the black group, they were also more likely to experience longer hospitals stays after five of the 16 procedures and had a greater chance of dying within 30 days of three of the surgeries.
One of the limitations of prior studies that have suggested narrowing disparities in healthcare outcomes for minority groups is narrow focus, according to the authors. Only looking at outcomes data related to one procedure or surgery may paint a different picture, whereas the broad scope of the Henry Ford study highlights the presence of significant disparities.