Introduction: Many strategies to alleviate racial/ethnic disparities in surgical care target healthcare providers. Yet limited data exists about the perception of disparities among the range of clinical staff who work in perioperative settings. Such information could help initiate conversations about disparities in perioperative care and, if necessary, implement interventions to alleviate them. Our aim was to evaluate the association between sociodemographic characteristics, clinical position (physicians and non-physicians) and perception of perioperative disparities at a large tertiary care center.
Methods: We surveyed perioperative staff at the institution using an anonymous online survey. Primary outcome was respondents' perception of disparities in perioperative care at the institution due to patients' insurance status/type, ability to speak English, education, and racial/ethnic minority status. The association between clinical position (physician vs. non-physician) and perception of disparities was assessed in bivariate and then multivariable analysis, adjusting for respondents' race, sex, age, and years at the institution. Secondary outcomes included perception of disparities in perioperative care in the United States due to patients' insurance status/type, ability to speak English, education, and racial/ethnic minority status.
Results: 217 completed questions that could be analyzed. Among these responders, 101 were physicians (46.5%), 165 (76.0%) were white, and 144 (66.4.%) were female. Bivariate and multivariate analysis revealed that physicians had higher perception of disparities in perioperative care at the institution based on patients' ability to speak English, education, and racial/ethnic minority status. Physicians also had higher perceptions of disparities in perioperative care in the United States than non-physicians.
Conclusions: Physicians reported higher perceptions of disparities in perioperative care than non-physicians, potentially explained by differences in training or contact with patients. Such findings serve as a first step at examining and discussing disparities in perioperative care and warrant further study.
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http://dx.doi.org/10.1016/j.jnma.2019.07.003 | DOI Listing |
Ann Thorac Surg Short Rep
December 2024
Division of Cardiology, Department of Pediatrics, Children's National Hospital, Washington, DC.
Background: Disadvantaged socioeconomic status correlates with adverse outcomes for patients with congenital heart disease. We examined individual and neighborhood characteristics associated with adverse short-term surgical outcomes and investigated potential drivers of disparities.
Methods: Single-center retrospective analysis collected clinical and demographic information on cardiovascular surgery patients over a 15-year period (2007-2022) from the District of Columbia metropolitan area.
J Surg Oncol
January 2025
Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Background And Objectives: Gastric adenocarcinoma (GA) is commonly treated with open or minimally invasive surgery (MIS). The preferred surgical approach remains unclear. This study sought to assess utilization over time, compare complication rates by surgical approach, and identify predictors of experiencing complications.
View Article and Find Full Text PDFBackground: Disparities in postoperative nausea and vomiting (PONV) and its prophylaxis may exist based on race, ethnicity, and socioeconomic status (SES). Our objective was to evaluate whether patients from racial and ethnic minority groups and patients from lower SES backgrounds received less appropriate PONV prophylaxis and experienced higher rates of PONV and post-discharge nausea and vomiting (PDNV).
Methods: This retrospective cohort study included 23,333 adults who underwent major surgeries (total knee arthroplasty, cholecystectomy, hysterectomy, and prostatectomy) from 2017-2022 in a single, multi-state hospital system.
Ann Surg
January 2025
Division of Colorectal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School; Boston, MA, USA.
Objective: To explore the association of socioeconomic status (SES) and race/ethnicity with perioperative metrics within the Enhanced Recovery After Surgery (ERAS) framework to identify gaps for equity-informed improvements.
Summary Background Data: Although ERAS pathways improve perioperative outcomes through standardized care, disparities in protocol adherence and postoperative outcomes persist, particularly for vulnerable populations.
Methods: We conducted a retrospective cohort study using a single-institution database of elective colorectal surgeries (2018-2021).
Syst Rev
January 2025
Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
Background: The inadequate inclusion of sex and gender in medical research has resulted in biased clinical guidance and disparities in knowledge and patient outcomes. Despite efforts by regulatory and funding agencies, opportunities to generate sex-specific knowledge are frequently overlooked. While certain disciplines in cardiovascular medicine have made notable progress, these advances have yet to permeate the literature on perioperative cardiovascular complications in non-cardiac surgery.
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