Racial Disparities in the Cost of Unplanned Hospitalizations after Breast Reconstruction.
Humans
Healthcare Disparities
/ economics
Hispanic or Latino
/ statistics & numerical data
Hospitalization
/ economics
Mammaplasty
/ adverse effects
Minority Groups
/ statistics & numerical data
Retrospective Studies
Race Factors
/ economics
Patient Readmission
/ economics
White
/ statistics & numerical data
Black or African American
/ statistics & numerical data
Health Expenditures
/ statistics & numerical data
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
01 08 2023
01 08 2023
Historique:
medline:
31
7
2023
pubmed:
3
2
2023
entrez:
2
2
2023
Statut:
ppublish
Résumé
Given the national attention to disparities in health care, understanding variation provided to minorities becomes increasingly important. This study will examine the effect of race on the rate and cost of unplanned hospitalizations after breast reconstruction procedures. The authors performed an analysis comparing patients undergoing implant-based and autologous breast reconstruction in the Healthcare Cost and Utilization Project. The authors evaluated the rate of unplanned hospitalizations and associated expenditures among patients of different races. Multivariable analyses were performed to determine the association among race and readmissions and health care expenditures. The cohort included 17,042 patients. The rate of an unplanned visit was 5%. The rates of readmissions among black patients (6%) and Hispanic patients (7%) in this study are higher compared with white patients (5%). However, after controlling for patient-level characteristics, race was not an independent predictor of an unplanned visit. In our expenditure model, black patients [adjusted cost ratio, 1.35 (95% CI, 1.11 to 1.66)] and Hispanic patients [adjusted cost ratio, 1.34 (95% CI, 1.08 to 1.65)] experienced greater cost for their readmission compared with white patients. Although race is not an independent predictor of an unplanned hospital visit after surgery, racial minorities bear a higher cost burden after controlling for insurance status, further stimulating health care disparities. Adjusted payment models may be a strategy to reduce disparities in surgical care. In addition, direct and indirect measures of disparities should be used when examining health care disparities to identify consequences of inequities more robustly.
Sections du résumé
BACKGROUND
Given the national attention to disparities in health care, understanding variation provided to minorities becomes increasingly important. This study will examine the effect of race on the rate and cost of unplanned hospitalizations after breast reconstruction procedures.
METHODS
The authors performed an analysis comparing patients undergoing implant-based and autologous breast reconstruction in the Healthcare Cost and Utilization Project. The authors evaluated the rate of unplanned hospitalizations and associated expenditures among patients of different races. Multivariable analyses were performed to determine the association among race and readmissions and health care expenditures.
RESULTS
The cohort included 17,042 patients. The rate of an unplanned visit was 5%. The rates of readmissions among black patients (6%) and Hispanic patients (7%) in this study are higher compared with white patients (5%). However, after controlling for patient-level characteristics, race was not an independent predictor of an unplanned visit. In our expenditure model, black patients [adjusted cost ratio, 1.35 (95% CI, 1.11 to 1.66)] and Hispanic patients [adjusted cost ratio, 1.34 (95% CI, 1.08 to 1.65)] experienced greater cost for their readmission compared with white patients.
CONCLUSIONS
Although race is not an independent predictor of an unplanned hospital visit after surgery, racial minorities bear a higher cost burden after controlling for insurance status, further stimulating health care disparities. Adjusted payment models may be a strategy to reduce disparities in surgical care. In addition, direct and indirect measures of disparities should be used when examining health care disparities to identify consequences of inequities more robustly.
Identifiants
pubmed: 36728197
doi: 10.1097/PRS.0000000000010200
pii: 00006534-202308000-00007
pmc: PMC10368219
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
281-290Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2023 by the American Society of Plastic Surgeons.
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