Journal article
Ethnic and economic disparities effect on management of hyperparathyroidism
The American journal of surgery, Vol.213(6), pp.1134-1142
06/01/2017
DOI: 10.1016/j.amjsurg.2016.07.008
PMID: 27771035
Abstract
Successful parathyroidectomy requires advanced surgeon experience. We aim to examine population characteristics at risk of being managed by low-volume surgeons.
A cross-sectional study was performed utilizing the Nationwide Inpatient Sample database, 2004 to 2009. The study population included adult inpatients who underwent parathyroidectomy for primary hyperparathyroidism.
A total of 3,503 discharge records were included. Men, Hispanics, and those with Medicaid/Medicare health coverage were more likely to be managed by low-volume surgeons (P < .05 each). Low-volume surgeons were more likely to operate in rural (odds ratio [OR], 3.99; 95% confidence interval [CI], 1.95 to 8.16; P < .001) or nonteaching hospitals (OR, 2.15; 95% CI, 1.42 to 3.27; P < .001). Southern region of the United States had a high prevalence of low-volume surgeons compared with other regions (Southern: 51.3%, Northeast: 24.3%, Midwest: 25.6%, and West: 27.6%, P < .001). Operations by the low-volume surgeons associated with a higher risk of postoperative complications (OR, 1.81; 95% CI, 1.11 to 2.97) and a hospital stay more than 2 days (OR, 7.12; 95% CI, 3.75 to 13.45; P < .001).
Certain populations are at risk of management by low-volume surgeons based on their demographic and economic characteristics.
•Certain demographics are at a higher risk of management by low-volume surgeon.•Imbalance in the distribution of low-volume surgeons.•Low-volume surgeons more likely to have unfavorable post-surgical outcomes.
Details
- Title: Subtitle
- Ethnic and economic disparities effect on management of hyperparathyroidism
- Creators
- Zaid Al-Qurayshi - Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USAAdam Hauch - Tulane UniversitySudesh Srivastav - Tulane UniversityEmad Kandil - Tulane University
- Resource Type
- Journal article
- Publication Details
- The American journal of surgery, Vol.213(6), pp.1134-1142
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjsurg.2016.07.008
- PMID
- 27771035
- ISSN
- 0002-9610
- eISSN
- 1879-1883
- Number of pages
- 9
- Language
- English
- Date published
- 06/01/2017
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984702937702771
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