Highlights
- •Unplanned surgery is more common among minoritized Medicare beneficiaries.
- •Mortality and readmissions increase for Asian & Black patients after unplanned surgery.
- •Reducing rates of unplanned surgery may mitigate overall surgical disparities.
Abstract
Background
While significant efforts have been made to understand surgical disparities for procedures
that are performed in either the elective or unplanned settings, far less is known
about procedures performed in both settings.
Methods
Cross-sectional study of 1,135,743 Medicare beneficiaries undergoing incisional hernia
repair, colectomy, or abdominal aortic aneurysm repair between 2014 and 2018. Risk-adjusted
outcomes were assessed using multivariable logistic regression.
Results
Compared to White beneficiaries, unplanned surgery rates were higher for Black (44.0%vs38.8%,
OR = 1.29,p < 0.001) and Asian beneficiaries(40.4%vs38.8%,OR = 1.09,p < 0.001). While
there were minimal differences in 30-day mortality for elective procedures, unplanned
procedures demonstrated wider disparities (Black vs White 12.4%vs11.3%,OR = 1.11,p < 0.001;
Asian vs White 13.2%vs11.3%,OR = 1.18,p < 0.001). Similar patterns were observed for
readmissions.
Conclusions
Unplanned procedures are more common and demonstrate wider disparities in outcomes
among minority Medicare beneficiaries. Reducing unplanned surgery rates among these
groups may be an effective strategy to limit overall disparities in postoperative
outcomes.
Keywords
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Article info
Publication history
Published online: August 28, 2022
Accepted:
August 24,
2022
Received in revised form:
August 19,
2022
Received:
February 10,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
