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Racial Disparities In Surgical Mortality The Gap Appears To Have Narrowed

Author: Winta Tsegay Mehtsun, José F. Figueroa, Jie Zheng, E. John Orav, Ashish K. Jha
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Despite substantial attention to the greater likelihood of poor clinical outcomes among black versus white surgical patients, little is known about whether racial disparities in postoperative mortality in the United States have narrowed over time. Using nationwide Medicare inpatient claims data for the period 2005–14, we examined trends in thirty-day postoperative mortality rates in black and white patients for five high-risk and three low-risk procedures. Overall, national mortality trends improved for both black and white patients, by 0.10 percent per year and 0.07 percent per year, respectively—which significantly narrowed the black-white difference. The reduction occurred primarily within hospitals, rather than between hospitals. Certain subsets of hospitals, such as small hospitals in the Midwest or West that were not minority-serving (that is, not among the top 10 percent of hospitals by volume of black patients served), improved more than others. In spite of concerns that quality improvement efforts may widen disparities, these findings suggest that national racial disparities in surgical mortality are narrowing.

Despite substantial attention to the greater likelihood of poor clinical outcomes among black versus white surgical patients, little is known about whether racial disparities in postoperative mortality in the United States have narrowed over time. Using nationwide Medicare inpatient claims data for the period 2005–14, we examined trends in thirty-day postoperative mortality rates in black and white patients for five high-risk and three low-risk procedures. Overall, national mortality trends improved for both black and white patients, by 0.10 percent per year and 0.07 percent per year, respectively—which significantly narrowed the black-white difference. The reduction occurred primarily within hospitals, rather than between hospitals. Certain subsets of hospitals, such as small hospitals in the Midwest or West that were not minority-serving (that is, not among the top 10 percent of hospitals by volume of black patients served), improved more than others. In spite of concerns that quality improvement efforts may widen disparities, these findings suggest that national racial disparities in surgical mortality are narrowing.

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