Disparities influencing rates of urgent/emergent surgery for diverticulitis in the state of Florida.

Abstract:

BACKGROUND:Patients with diverticulitis have a 20% risk of requiring urgent/emergent treatment. Since morbidity and mortality rates differ between elective and urgent/emergent care, understanding associated disparities is critical. We compared factors associated with treatment setting for diverticulitis and evaluated disparities regarding access to Minimally Invasive Surgery (MIS) and development of complications. METHODS:The Florida Inpatient Discharge Dataset was queried for patients diagnosed with diverticulitis. Three multivariate models were utilized: 1) elective vs urgent/emergent surgery, 2) MIS vs open and 3) presence of complications. RESULTS:The analysis included 12,654 patients. Factors associated with increased odds of urgent/emergent care included being uninsured or covered by Medicaid, African American, obese, or more comorbid. MIS was associated with reduced odds of complications. Patients treated by high-volume or colorectal surgeons had increased odds of receiving MIS. CONCLUSIONS:Patients were more likely to receive MIS if they were treated by a colorectal surgeon, or a high-volume surgeon (colorectal, or general surgeon). Additionally, patients that were older, had increased comorbidities, or did not have health insurance were less likely to receive MIS.

journal_name

Am J Surg

authors

Lemini R,Spaulding AC,Osagiede O,Cochuyt JJ,Naessens JM,Crandall M,Cima RR,Colibaseanu DT

doi

10.1016/j.amjsurg.2019.09.005

subject

Has Abstract

pub_date

2020-06-01 00:00:00

pages

1012-1018

issue

6

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(19)30991-2

journal_volume

219

pub_type

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