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 24 November 2017

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News

Race and health insurance predict bowel resection in Crohn's

The latest issue of Inflammatory Bowel Diseases identifies factors that predict bowel resection in hospitalized Crohn's disease patients.

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Racial disparities in utilization of major surgical procedures have been well documented in the United States over the last decade.

Crohn's disease is a chronically relapsing disorder that leads to significant morbidity and, in most cases, surgery.

Dr Geoffrey Nguyen and colleagues from Maryland, USA characterized health disparities in Crohn's disease-related bowel resection among hospitalized patients.

The research team analyzed 41,918 discharge records from the Nationwide Inpatient Sample from 1998 to 2003.

The relative risk of surgery for those who were self-pay was 0.7
Inflammatory Bowel Diseases

This is largest nationally representative database of acute-care hospitals throughout the United States.

Bowel resection and in-hospital mortality rates for non-Hispanic whites, African Americans, Hispanics, and non-Hispanic Asians were calculated.

The research team adjusted for age, sex, health insurance, comorbidity, median neighborhood income, and hospital characteristics.

The team found that the relative rate ratio of undergoing bowel resection for African Americans and Hispanics was 0.7 compared to whites.

The relative rate ratio of undergoing bowel resection for Asians compared to whites was 0.3.

Compared to those with private insurance, the relative risk of surgery for those with Medicare and those with Medicaid was 0.5.

The team observed that the relative risk of surgery for those who were self-pay was 0.7.

Women were less likely than men to undergo bowel resection.

The researchers noted that the in-hospital mortality of individuals who resided in neighborhoods whose median income was above the national median was lower.

Dr Nguyen's team concludes, "Bowel resection among hospitalized Crohn's disease patients varies by race, health insurance, and sex."

"Further mechanistic studies are needed to elucidate the social and biological underpinnings of these variations."

Inflamm Bowel Dis 2007: 13(11): 1408-16
17 October 2007

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