Full Citation
Title: Association of County-Level Racial Diversity and Likelihood of a Textbook Outcome Following Pancreas Surgery
Citation Type: Journal Article
Publication Year: 2021
ISBN:
ISSN: 15344681
DOI: 10.1245/S10434-021-10316-3/TABLES/4
NSFID:
PMCID:
PMID: 34143339
Abstract: Introduction: Residential racial desegregation has demonstrated improved economic and education outcomes. The degree of racial community segregation relative to surgical outcomes has not been examined. Patients and Methods: Patients undergoing pancreatic resection between 2013 and 2017 were identified from Medicare Standard Analytic Files. A diversity index for each county was calculated from the American Community Survey. Multivariable mixed-effects logistic regression with a random effect for hospital was used to measure the association of the diversity index level with textbook outcome (TO). Results: Among the 24,298 Medicare beneficiaries who underwent a pancreatic resection, most patients were male (n = 12,784, 52.6%), White (n = 21,616, 89%), and had a median age of 72 (68–77) years. The overall incidence of TO following pancreatic surgery was 43.3%. On multivariable analysis, patients who resided in low-diversity areas had 16% lower odds of experiencing a TO following pancreatic resection compared with patients from high-diversity communities (OR 0.84, 95% CI 0.72–0.98). Compared with patients who resided in the high-diversity areas, individuals who lived in low-diversity areas had higher odds of 90-day readmission (OR 1.16, 95% CI 1.03–1.31) and had higher odds of dying within 90 days (OR 1.85, 95% CI 1.45–2.38) (both p < 0.05). Nonminority patients who resided in low-diversity areas also had a 14% decreased likelihood to achieve a TO after pancreatic resection compared with nonminority patients in high-diversity areas (OR 0.86, 95% CI 0.73–1.00). Conclusion: Patients residing in the lowest racial/ethnic integrated counties were considerably less likely to have an optimal TO following pancreatic resection compared with patients who resided in the highest racially integrated counties.
Url: https://link.springer.com/article/10.1245/s10434-021-10316-3
User Submitted?: No
Authors: Diaz, Adrian; Dalmacy, Djhenne; Herbert, Chelsea; Mirdad, Rayyan S.; Hyer, J. Madison; Pawlik, Timothy M.
Periodical (Full): Annals of Surgical Oncology
Issue:
Volume: 28
Pages: 8076-8084
Data Collections: IPUMS NHGIS
Topics: Health, Race and Ethnicity
Countries: