Disparities in minimally invasive surgery for colorectal cancer in Florida

Osayande Osagiede, Aaron Spaulding, Jordan J. Cochuyt, James M Naessens, Amit Merchea, Pashtoon M. Kasi, Marie Crandall, Dorin T. Colibaseanu

Research output: Contribution to journalArticle

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Abstract

Background: The cost of minimally invasive surgery (MIS) raises potential for racial and social disparities. The aim of this study was to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer (CRC) in Florida. Methods: Using the Florida Inpatient Discharge Dataset, we examined the clinical data of patients who underwent elective resections for CRC during 2013–2015. Multivariable analysis was performed to identify differences in gender, age, race, urbanization, region, insurance and clinical characteristics associated with the surgical approach. Results: Of the 10,224 patients identified, 5308 (52%) had open surgery and 4916 (48%) had MIS. Females (p = 0.012), Medicare-insured patients (p = 0.001) and residents of South Florida were more likely to undergo MIS. Patients with Medicaid (p = 0.008), metastasis (p < 0.001) or 3–5 comorbidities (p = 0.004) had reduced likelihood of MIS. Hispanic patients in Southwest Florida had reduced likelihood of receiving MIS than whites (p < 0.017). Patients who underwent MIS had significantly reduced LOS (p < 0.001). Conclusions: Consistent with national studies, MIS for CRC in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparities in MIS for CRC in Florida. We analyzed a statewide database in Florida to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer at the state level. Consistent with national studies, MIS for colorectal cancer in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparity in MIS for colorectal cancer in Florida.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jan 1 2018

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Minimally Invasive Surgical Procedures
Colorectal Neoplasms
Geographic Locations
Insurance Coverage
Urbanization
Medicaid
Medicare
Insurance
Hispanic Americans
Comorbidity
Inpatients
Databases

Keywords

  • Colorectal cancer
  • Florida
  • Health disparities
  • Minimally invasive surgery
  • Retrospective study

ASJC Scopus subject areas

  • Surgery

Cite this

Disparities in minimally invasive surgery for colorectal cancer in Florida. / Osagiede, Osayande; Spaulding, Aaron; Cochuyt, Jordan J.; Naessens, James M; Merchea, Amit; Kasi, Pashtoon M.; Crandall, Marie; Colibaseanu, Dorin T.

In: American Journal of Surgery, 01.01.2018.

Research output: Contribution to journalArticle

Osagiede, Osayande ; Spaulding, Aaron ; Cochuyt, Jordan J. ; Naessens, James M ; Merchea, Amit ; Kasi, Pashtoon M. ; Crandall, Marie ; Colibaseanu, Dorin T. / Disparities in minimally invasive surgery for colorectal cancer in Florida. In: American Journal of Surgery. 2018.
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title = "Disparities in minimally invasive surgery for colorectal cancer in Florida",
abstract = "Background: The cost of minimally invasive surgery (MIS) raises potential for racial and social disparities. The aim of this study was to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer (CRC) in Florida. Methods: Using the Florida Inpatient Discharge Dataset, we examined the clinical data of patients who underwent elective resections for CRC during 2013–2015. Multivariable analysis was performed to identify differences in gender, age, race, urbanization, region, insurance and clinical characteristics associated with the surgical approach. Results: Of the 10,224 patients identified, 5308 (52{\%}) had open surgery and 4916 (48{\%}) had MIS. Females (p = 0.012), Medicare-insured patients (p = 0.001) and residents of South Florida were more likely to undergo MIS. Patients with Medicaid (p = 0.008), metastasis (p < 0.001) or 3–5 comorbidities (p = 0.004) had reduced likelihood of MIS. Hispanic patients in Southwest Florida had reduced likelihood of receiving MIS than whites (p < 0.017). Patients who underwent MIS had significantly reduced LOS (p < 0.001). Conclusions: Consistent with national studies, MIS for CRC in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparities in MIS for CRC in Florida. We analyzed a statewide database in Florida to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer at the state level. Consistent with national studies, MIS for colorectal cancer in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparity in MIS for colorectal cancer in Florida.",
keywords = "Colorectal cancer, Florida, Health disparities, Minimally invasive surgery, Retrospective study",
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AU - Cochuyt, Jordan J.

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AU - Merchea, Amit

AU - Kasi, Pashtoon M.

AU - Crandall, Marie

AU - Colibaseanu, Dorin T.

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N2 - Background: The cost of minimally invasive surgery (MIS) raises potential for racial and social disparities. The aim of this study was to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer (CRC) in Florida. Methods: Using the Florida Inpatient Discharge Dataset, we examined the clinical data of patients who underwent elective resections for CRC during 2013–2015. Multivariable analysis was performed to identify differences in gender, age, race, urbanization, region, insurance and clinical characteristics associated with the surgical approach. Results: Of the 10,224 patients identified, 5308 (52%) had open surgery and 4916 (48%) had MIS. Females (p = 0.012), Medicare-insured patients (p = 0.001) and residents of South Florida were more likely to undergo MIS. Patients with Medicaid (p = 0.008), metastasis (p < 0.001) or 3–5 comorbidities (p = 0.004) had reduced likelihood of MIS. Hispanic patients in Southwest Florida had reduced likelihood of receiving MIS than whites (p < 0.017). Patients who underwent MIS had significantly reduced LOS (p < 0.001). Conclusions: Consistent with national studies, MIS for CRC in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparities in MIS for CRC in Florida. We analyzed a statewide database in Florida to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer at the state level. Consistent with national studies, MIS for colorectal cancer in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparity in MIS for colorectal cancer in Florida.

AB - Background: The cost of minimally invasive surgery (MIS) raises potential for racial and social disparities. The aim of this study was to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer (CRC) in Florida. Methods: Using the Florida Inpatient Discharge Dataset, we examined the clinical data of patients who underwent elective resections for CRC during 2013–2015. Multivariable analysis was performed to identify differences in gender, age, race, urbanization, region, insurance and clinical characteristics associated with the surgical approach. Results: Of the 10,224 patients identified, 5308 (52%) had open surgery and 4916 (48%) had MIS. Females (p = 0.012), Medicare-insured patients (p = 0.001) and residents of South Florida were more likely to undergo MIS. Patients with Medicaid (p = 0.008), metastasis (p < 0.001) or 3–5 comorbidities (p = 0.004) had reduced likelihood of MIS. Hispanic patients in Southwest Florida had reduced likelihood of receiving MIS than whites (p < 0.017). Patients who underwent MIS had significantly reduced LOS (p < 0.001). Conclusions: Consistent with national studies, MIS for CRC in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparities in MIS for CRC in Florida. We analyzed a statewide database in Florida to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer at the state level. Consistent with national studies, MIS for colorectal cancer in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparity in MIS for colorectal cancer in Florida.

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KW - Health disparities

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KW - Retrospective study

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