Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 22 November 2017

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Insurance status and race affects likelihood of laparoscopic appendectomy

In October's Journal of the American College of Surgeons, a report using secondary data finds that insurance status and race are marked independent predictors of having laporoscopic surgery in patients treated for appendicitis.

News image

fiogf49gjkf04

Previous studies have shown that racial and socioeconomic differences lead to inequality in access to health care.

However, until now it has been unknown whether insurance status and race affect the choice of surgical treatment for patients presenting with appendicitis.

Dr Guller's research team from Switzerland, selected patients with primary ICD-9 procedure codes for laparoscopic and open appendectomy from the 1998, 1999, and 2000 Nationwide (US) Inpatient Samples.

Caucasian patients and Hispanics are more likely to have laparoscopic appendectomy, compared with African Americans

Journal of the American College of Surgeons

The group chose the primary predictor variables to be: insurance status (private, Medicare, Medicaid, other) and race (Caucasian, African American, Hispanic, other).

The research team used multiple logistic regression models to assess whether insurance status and race are associated with the choice of surgical procedure for patients presenting with appendicitis.

In total, 145,546 patients' discharge abstracts were used in the researchers' analyses.

There were 32,407 patients (22.3%) who underwent laparoscopic appendectomy and 113,139 patients (77.7%) who had open appendectomy.

The group found that although 24.2% of privately insured patients underwent laparoscopic appendectomy, only 16.9% of Medicare patients, 17.4% of Medicaid patients, and 19.6% of patients in the “other” insurance category were treated using the laparoscopic procedure.

In addition, the researchers found that caucasian patients underwent laparoscopic surgery in 24.8%, African Americans in 18.6%, Hispanics in 19.6%, and other ethnicities in 18.8% of patients (p < 0.001).

The group was able to reveal that privately insured patients and Medicare patients, compared with the Medicaid subset, after adjusting for potential confounders such as age, gender, race, patient comorbidity, median ZIP code income, hospital location and teaching status, and presence of abscess or perforation, were significantly more likely to undergo laparoscopic surgery.

Caucasian patients and Hispanics were found to be significantly more likely to have laparoscopic appendectomy, compared with African Americans, even after adjusting for the previously mentioned confounders and insurance status.

Dr Guller concluded, "Even after adjusting for potential confounders, insurance status and race are marked independent predictors of having laparoscopic surgery in patients treated for appendicitis in this sample".

Journal of the American College of Surgeons 2004: 199 (4): 567-575
01 October 2004

Go to top of page Email this page Email this page to a colleague

 22 November 2017 
Challenges of US-trained gastroenterologists when abroad
 22 November 2017 
Surgical treatment delays influence survival in colon cancer
 22 November 2017 
Golimumab in Crohn's disease
 21 November 2017 
Preoperative optimization in IBD patients
 21 November 2017 
Cholangiopathy in critically ill patients
 21 November 2017 
Prepregnancy obesity and maternal mortality
 20 November 2017 
Socioeconomic characteristics in diverticular disease
 20 November 2017 
Barriers to hepatitis C treatment
 20 November 2017 
Endoscopic indices of disease activity for Crohn’s
 17 November 2017 
Food elimination diets for treatment of adults with eosinophilic esophagitis
 17 November 2017 
PPI use and cognitive function in women
 17 November 2017 
Predicting microscopic colitis
 16 November 2017 
NAFLD-hepatocellular carcinoma and survival after orthotopic liver transplant
 16 November 2017 
Prepregnancy obesity and severe maternal morbidity
 16 November 2017 
Celiac disease screening in adult first-degree relatives
 15 November 2017 
Breastfeeding and the risk of IBD
 15 November 2017 
Medication nonadherence and health care costs
 15 November 2017 
Predicting recurrence after curative rectal cancer surgery
 14 November 2017 
HBV/HCV coinfection and cirrhosis
 14 November 2017 
Sexual dysfunction after rectal cancer surgery
 14 November 2017 
Eosinophilic gastroenteritis and colitis
 13 November 2017 
GI bleeding in patients taking non–vitamin K antagonist oral anticoagulants
 13 November 2017 
Genetic polymorphisms, fatty acids and ulcerative colitis
 13 November 2017 
Flares after immunomodulator withdrawal in Crohn's
 10 November 2017 
Thiopurines vs TNF and lymphoma risk in IBD
 10 November 2017 
Drug monitoring of anti-tumour necrosis factor therapy in IBD
 10 November 2017 
Treatment decisions for older patients with colorectal cancer
 09 November 2017 
Quality standards in upper gastrointestinal endoscopy
 09 November 2017 
Irradiated rectal cancer and chemoradiotherapy
 09 November 2017 
Environmental factors and IBD
 08 November 2017 
Prophylaxis of spontaneous bacterial peritonitis
 08 November 2017 
Optimal management of postoperative Crohn's disease
 07 November 2017 
Community Screening for Helicobacter pylori
 07 November 2017 
Early readmission in IBD patients
 07 November 2017 
Mesocolic excision for colon cancer
 06 November 2017 
Food elimination diet for children with eosinophilic esophagitis
 06 November 2017 
Biologic agents and obesity in children with IBD
 06 November 2017 
Liver cancer burden despite extensive use of antiviral agents
 03 November 2017 
Statins and mortality in chronic viral hepatitis
 03 November 2017 
Propofol for outpatient colonoscopy
 03 November 2017 
Asthma and IBD development
 02 November 2017 
Diverticulitis and emergency department burden
 02 November 2017 
Sexual functioning in Hep C
 02 November 2017 
Rural residence and risk of IBD
 01 November 2017 
Heartburn relief in adolescents with GERD
 01 November 2017 
Autoimmune pancreatitis in children
 31 October 2017 
Follow-up of positive results on fecal blood tests
 31 October 2017 
Surveillance in ulcerative colitis and Crohn’s disease
 30 October 2017 
Local recurrence after curative rectal cancer surgery
 30 October 2017 
Low-flow ascites pump in refractory cirrhosis
 30 October 2017 
Medical therapy of patients with pediatric-onset IBD
 27 October 2017 
NAFLD in advanced fibrosis in the USA
 27 October 2017 
Early readmission in cirrhosis after bacterial infections
 26 October 2017 
Predicting response to anti-TNF therapy in Crohn's
 26 October 2017 
Conversion to open laparotomy in rectal cancer
 25 October 2017 
Conversion of colonoscopy to sigmoidoscopy
 25 October 2017 
Fecal microbiota transplantation
 25 October 2017 
Rifaximin and survival in hepatic encephalopathy
 24 October 2017 
Eosinophilic esophagitis with swallowed topical corticosteroids
 24 October 2017 
Meta-analysis in nutritiona research

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2017 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us