Abstract:
OBJECTIVE:To evaluate the impact of health insurance expansion on racial disparities in severity of peripheral arterial disease. BACKGROUND:Lack of insurance and non-white race are associated with increased severity, increased amputation rates, and decreased revascularization rates in patients with peripheral artery disease (PAD). Little is known about how expanded insurance coverage affects disparities in presentation with and management of PAD. The 2006 Massachusetts health reform expanded coverage to 98% of residents and provided the framework for the Affordable Care Act. METHODS:We conducted a retrospective cohort study of nonelderly, white and non-white patients admitted with PAD in Massachusetts (MA) and 4 control states. Risk-adjusted difference-in-differences models were used to evaluate changes in probability of presenting with severe disease. Multivariable linear regression models were used to evaluate disparities in disease severity before and after the 2006 health insurance expansion. RESULTS:Before the 2006 MA insurance expansion, non-white patients in both MA and control states had a 12 to 13 percentage-point higher probability of presenting with severe disease (P < 0.001) than white patients. After the expansion, measured disparities in disease severity by patient race were no longer statistically significant in Massachusetts (+3.0 percentage-point difference, P = 0.385) whereas disparities persisted in control states (+10.0 percentage-point difference, P < 0.001). Overall, non-white patients in MA had an 11.2 percentage-point decreased probability of severe PAD (P = 0.042) relative to concurrent trends in control states. CONCLUSIONS:The 2006 Massachusetts insurance expansion was associated with a decreased probability of patients presenting with severe PAD and resolution of measured racial disparities in severe PAD in MA.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Loehrer AP,Hawkins AT,Auchincloss HG,Song Z,Hutter MM,Patel VIdoi
10.1097/SLA.0000000000001310subject
Has Abstractpub_date
2016-04-01 00:00:00pages
705-11issue
4eissn
0003-4932issn
1528-1140journal_volume
263pub_type
杂志文章abstract::Eighty-five (23%) of 375 patients undergoing surgery for primary hyperparathyroidism were found to have enlargement (greater than 50 mg) of two or three parathyroid glands. Of 76 patients followed from 12 to 140 months after surgery, eight (10.5%) developed hypercalcemia at 1, 4, 45, 64, 74, 79, 84, and 133 months. In...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198511000-00001
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVE:To determine the prognostic influence of residual tumor at or within 1 mm of the mobilization margins (R1Mobilization) compared with transection margins (R1Transection) following pancreaticoduodenectomy for pancreatic ductal adenocarcinoma (PDAC). BACKGROUND:The prognostic strength of R1 status increases wit...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181d77369
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVE:To determine the association between race/ethnicity and perioperative outcomes in individuals undergoing major oncologic and nononcologic surgical procedures in the United States. BACKGROUND:Prior work has shown that there are significant racial/ethnic disparities in perioperative outcomes after several type...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001078
更新日期:2015-12-01 00:00:00
abstract::A technique for repairing benign hilar hepatic duct strictures using transhepatic intubation with a large bore silastic stent is described. This procedure has been used in 10 patients. In 9 instances the stricture involved the common hepatic duct, and in one patient the right and left hepatic ducts. Nine of the strict...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197605000-00005
更新日期:1976-05-01 00:00:00
abstract:OBJECTIVE:To evaluate clinical parameters, presurgical diagnostic tests, histologic findings, and the presence of K-ras oncogene mutations in cystic tumors of the pancreas to determine which best predict malignancy. SUMMARY BACKGROUND DATA:Because presurgical, intraoperative, and final pathologic differentiation is di...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199807000-00012
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:To perform a systematic review and meta-analysis of studies comparing operative to nonoperative therapy in adult FC patients. Outcomes were duration of mechanical ventilation (DMV), intensive care unit length of stay (ICULOS), hospital length of stay (HLOS), mortality, incidence of pneumonia, and tracheostomy...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1097/SLA.0b013e3182895bb0
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Retrospective single-center studies have shown that diffusion-weighted magnetic resonance imaging (DWI) is promising for identification of patients with rectal cancer with a complete tumor response after neoadjuvant chemoradiotherapy (CRT), using certain volumetric thresholds. OBJECTIVE:This study aims to v...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000909
更新日期:2015-12-01 00:00:00
abstract::We studied a series of 26 cases of carcinoma of the ampulla of Vater. There were 24 adenocarcinomas and two neuroendocrine tumors. Histologically the carcinomas could be divided into tumors arising from periampullary duodenal mucosa and those arising within the ampulla. True ampullary tumors had a significantly better...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198908000-00006
更新日期:1989-08-01 00:00:00
abstract:OBJECTIVE:To determine the significance of the extent of mesorectal tumor invasion as a prognostic factor for T3 rectal cancer patients. SUMMARY BACKGROUND DATA:There is controversy as to which primary lesion characteristics, other than regional lymph node involvement, in T3 rectal cancer are reliable prognostic facto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000205627.05769.08
更新日期:2006-04-01 00:00:00
abstract::Adenocarcinoma involving the distal esophagus usually is far advanced when the patient is first seen. Adenocarcinoma differs from squamous carcinoma of the esophagus since it is relatively unresponsive to radiation therapy or chemotherapy. Adenocarcinoma of the esophagus resembles gastric cancer in its tendency to for...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198705000-00015
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:To explore challenges and opportunities for surgery departments' academic missions as they become increasingly affiliated with expanding health systems. SUMMARY BACKGROUND DATA:Academic medicine is in the midst of unprecedented change. In addition to facing intense competition, narrower margins, and decrease...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000004462
更新日期:2020-11-12 00:00:00
abstract::Tissue reaction to sutures was studied in 666 specimens obtained from patients from one day to 23 years after operation. Reaction to catgut depends on the stage of absorption and is mainly histocytic in type. Nonabsorbable sutures are encapsulated by a rim of connective tissue, while near the suture histocytes, giant ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197502000-00003
更新日期:1975-02-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy of oral supplementation of the gut enzyme intestinal alkaline phosphatase (IAP) in preventing antibiotic-associated infections from Salmonella enterica serovar Typhimurium (S. Typhimurium) and Clostridium difficile. BACKGROUND:The intestinal microbiota plays a pivotal role in human ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31828fae14
更新日期:2014-04-01 00:00:00
abstract::The aim of this study was to determine the long-term outcome among 390 patients with ulcerative colitis who underwent ileal J pouch-anal anastomosis and whether patient or operative factors influenced results. The combined operative morbidity rate for the pouch-anal anastomosis and the subsequent closure of the tempor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198710000-00011
更新日期:1987-10-01 00:00:00
abstract:OBJECTIVE:This study aims to review the operative results and oncological outcomes of anterior resection for rectal and rectosigmoid cancer. Comparison was made between patients with total mesorectal excision (TME) for mid and distal cancer and partial mesorectal excision (PME) for proximal cancer, when a 4- to 5-cm me...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000133185.23514.32
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:Comparison of short- and long-term effects after laparoscopic Heller myotomy (LHM) and endoscopic balloon dilation (EBD) considering the need for retreatment. BACKGROUND:Previously published studies have indicated that LHM is the most effective treatment for Achalasia. In contrast to that a recent randomized...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000000212
更新日期:2013-12-01 00:00:00
abstract::This paper presents a 23-year follow-up of the separation of ischiopagus tetrapus conjoined twins reported in Annals of Surgery in December 1966. One twin died of septicemia at age 2 years after bilateral pelvic osteotomies for the treatment of her marked pelvic diastasis. The surviving twin has done reasonably well, ...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-198911000-00017
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:To determine if addition of the S-nitrosylating agent ethyl nitrite (ENO) to the preservation solution can improve perfusion parameters in pumped human kidneys. BACKGROUND:A significant percentage of actively stored kidneys experience elevations in resistance and decreases in flow rate during the ex vivo sto...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000003702
更新日期:2019-12-05 00:00:00
abstract:OBJECTIVE:Create and validate diverticulitis surgical site infection prediction scale. BACKGROUND:Surgical site infections cause significant morbidity after colorectal surgery. An infection prediction scale could target infection prevention bundles to high-risk patients. METHODS:Prospectively collected National Surgi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002859
更新日期:2019-12-01 00:00:00
abstract::During a 29-month trial, 65 patients with acute gallstone pancreatitis were randomly selected for biliary tract explorations either within 73 hours of admission (36 patients) or at three months following remission with nonoperative measures (29 patients, with five others awaiting elective operation). The details of su...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198109000-00008
更新日期:1981-09-01 00:00:00
abstract::Continuous epidural anesthesia offers special advantages for patients with vascular disease. In 193 patients who had this technique employed for aortofemoral arteriography, profound pain relief was provided and the accompanying vasodilation produced superior demonstration of collateral and small distal vessels. Eleven...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00015
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether weekday of esophagectomy impacts 30-day mortality, and short- and long-term oncologic outcomes in esophageal cancer. SUMMARY OF BACKGROUND DATA:Recent literature suggests a relationship between the weekday of esophagectomy and overall survival. This finding coul...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001909
更新日期:2017-07-01 00:00:00
abstract::A stapling instrument is described for end-to-end inverting anastomoses applicable principally to low rectal anastomosis or esophagogastric or esophagojejunal anastomosis. The instrument creates an inverting anastomosis held by a double staggered row of stainless steel wire staples creating an anastomosis 21.2 mm inte...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197906000-00017
更新日期:1979-06-01 00:00:00
abstract:OBJECTIVE:The authors determined the incidence of complications in 133 patients who had undergone staging laparotomy with splenectomy before treatment for Hodgkin's disease (stages I-IV). METHODS AND MATERIALS:Medical records were reviewed, and the patients or their relatives were interviewed. Median follow-up after l...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199406000-00004
更新日期:1994-06-01 00:00:00
abstract::Twelve children underwent elective laparoscopic cholecystectomy for symptomatic cholelithiasis during a 10-month period in one institution. The operative technique that has been described for adults was modified because of the smaller dimensions of pediatric patients. These modifications are discussed in this report, ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199202000-00015
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:Congenital diaphragmatic hernia (CDH) remains a significant cause of neonatal morbidity and mortality. SUMMARY OF BACKGROUND DATA:Previous studies have suggested that hospital volume is an independent predictor of in-hospital mortality. We sought to validate this effect using a large national database incor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181f5b538
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To review the methodology employed in surgical mortality studies to control for potential confounders. SUMMARY BACKGROUND DATA:Nationwide hospital data are increasingly used to investigate surgical outcomes. However, poor data granularity and coding inaccuracies may lead to flawed findings. METHODS:We condu...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000002119
更新日期:2017-06-01 00:00:00
abstract:UNLABELLED:SUMMARY BACKGROUND DATA AND OBJECTIVE: Persistent pain affects everyday activities in 5% to 8% of patients after groin hernia repair. Because previous reports on the effect of neurectomy and/or mesh removal suffer from methodological problems we performed a detailed prospective trial of the effect of neurect...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0b013e31818eec49
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Hospitals increasingly rely on surgical quality assessment programs that require considerable resources to capture outcomes after hospital discharge. However, it is unclear whether capturing postdischarge complications and deaths is important. Our objectives were (1) to determine the frequency of postdischar...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181e4846e
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:We aimed to describe our living-donor liver transplantation (LDLT) surgical technique and its long-term patency for patients with Budd-Chiari syndrome (BCS) and retrohepatic inferior vena cava (IVC) obstruction that extends up to the atrium. BACKGROUND:From a technical perspective, LDLT for BCS with an IVC o...
journal_title:Annals of surgery
pub_type: 信件
doi:10.1097/SLA.0000000000002847
更新日期:2019-04-01 00:00:00