Comparing outcomes of cholecystectomies in white vs. minority patients

Olivia Tsai; Navid Fakourfar; Omaer Muttalib; Cesar Figueroa; Katharine A Kirby; Sebastian Schubl; Cristobal Barrios

doi:10.1016/j.amjsurg.2022.08.006

Comparing outcomes of cholecystectomies in white vs. minority patients

Am J Surg. 2022 Dec;224(6):1468-1472. doi: 10.1016/j.amjsurg.2022.08.006. Epub 2022 Aug 18.

Authors

Olivia Tsai¹, Navid Fakourfar², Omaer Muttalib³, Cesar Figueroa⁴, Katharine A Kirby⁵, Sebastian Schubl⁶, Cristobal Barrios⁷

Affiliations

¹ Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA. Electronic address: tsaio@uci.edu.
² Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA. Electronic address: fakourfn@uci.edu.
³ Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA. Electronic address: omuttali@hs.uci.edu.
⁴ Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA. Electronic address: figuerc1@hs.uci.edu.
⁵ Department of Statistics, University of California, Irvine, USA. Electronic address: kathark@uci.edu.
⁶ Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA. Electronic address: sschubl@hs.uci.edu.
⁷ Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, 3800 W. Chapman Ave, Suite 6200, Orange, CA 92868, USA. Electronic address: cbarrios@hs.uci.edu.

Abstract

Background: This study aimed to investigate the disparity between white and minority patients undergoing cholecystectomies, including presentation, outcomes, and financial burden.

Methods: This was an IRB approved retrospective review of all cholecystectomies at an academic medical center from 2013 to 2018. Data collected include demographics, insurance type, charge of admission, and clinical outcomes.

Results: 1539 patients underwent cholecystectomies. Of those, 36.9% were white and 63.1% were minority. Minority patients presented at a younger age than white patients (45.5 vs 53.9, p < 0.01) and required emergent admission (76.2% vs 68.4%, p < 0.01). No significant difference was found for clinical outcomes between white and minority. Minority patients were more commonly uninsured (32.1%). Among the uninsured, self-pay had a higher charge than emergency MediCal (by 5.46 per 1000 dollars).

Conclusion: Minority patients are more commonly disadvantaged at presentation and charged more due to insurance status despite similar outcomes after cholecystectomies.

Keywords: Charge; Cholecystectomy; Insurance; Socioeconomic status.

MeSH terms

Cholecystectomy*
Ethnic and Racial Minorities
Humans
Insurance Coverage
Medically Uninsured
Retrospective Studies
Social Determinants of Health
Treatment Outcome
White

Grants and funding

UL1 TR001414/TR/NCATS NIH HHS/United States