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Disparities in minimally invasive surgery for colorectal cancer in Florida

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. Using the Florida Inpatient Discharge Dataset, we ex... Full description

Journal Title: The American journal of surgery 2019-08, Vol.218 (2), p.293-301
Main Author: Osagiede, Osayande
Other Authors: Spaulding, Aaron C , Cochuyt, Jordan J , Naessens, James M , Merchea, Amit , Kasi, Pashtoon M , Crandall, Marie , Colibaseanu, Dorin T
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: United States: Elsevier Inc
ID: ISSN: 0002-9610
Link: https://www.ncbi.nlm.nih.gov/pubmed/30503514
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title: Disparities in minimally invasive surgery for colorectal cancer in Florida
format: Article
creator:
  • Osagiede, Osayande
  • Spaulding, Aaron C
  • Cochuyt, Jordan J
  • Naessens, James M
  • Merchea, Amit
  • Kasi, Pashtoon M
  • Crandall, Marie
  • Colibaseanu, Dorin T
subjects:
  • Abridged Index Medicus
  • Adolescent
  • Adult
  • African Americans
  • Aged
  • Aged, 80 and over
  • Analysis
  • Cancer
  • Colorectal cancer
  • Colorectal carcinoma
  • Colorectal Neoplasms - surgery
  • Datasets
  • Ethnicity
  • Female
  • Females
  • Florida
  • Geographical locations
  • Government programs
  • Health aspects
  • Health disparities
  • Healthcare Disparities - statistics & numerical data
  • Hispanic Americans
  • Hospitals
  • Humans
  • Insurance
  • Invasiveness
  • Laparoscopy
  • Male
  • Medicaid
  • Metastases
  • Metastasis
  • Middle Aged
  • Minimally invasive surgery
  • Minimally Invasive Surgical Procedures - statistics & numerical data
  • Oncology, Experimental
  • Patients
  • Race
  • Retrospective Studies
  • Retrospective study
  • Robotics
  • Social aspects
  • Socioeconomic factors
  • Surgeons
  • Surgery
  • Urbanization
  • Variables
  • Young Adult
ispartof: The American journal of surgery, 2019-08, Vol.218 (2), p.293-301
description: 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. 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. 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 
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 0002-9610
fulltext: fulltext
issn:
  • 0002-9610
  • 1879-1883
url: Link


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creatorOsagiede, Osayande ; Spaulding, Aaron C ; Cochuyt, Jordan J ; Naessens, James M ; Merchea, Amit ; Kasi, Pashtoon M ; Crandall, Marie ; Colibaseanu, Dorin T
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descriptionThe 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. 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. 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). 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. •National disparities in minimally invasive surgery (MIS) are well documented.•There is a paucity of state level data to corroborate or complement national findings.•Consistent with national studies, MIS for colorectal cancer in Florida is associated with insurance status and location.•Racial disparity for MIS in Florida differs by state regions. 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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subjectAbridged Index Medicus ; Adolescent ; Adult ; African Americans ; Aged ; Aged, 80 and over ; Analysis ; Cancer ; Colorectal cancer ; Colorectal carcinoma ; Colorectal Neoplasms - surgery ; Datasets ; Ethnicity ; Female ; Females ; Florida ; Geographical locations ; Government programs ; Health aspects ; Health disparities ; Healthcare Disparities - statistics & numerical data ; Hispanic Americans ; Hospitals ; Humans ; Insurance ; Invasiveness ; Laparoscopy ; Male ; Medicaid ; Metastases ; Metastasis ; Middle Aged ; Minimally invasive surgery ; Minimally Invasive Surgical Procedures - statistics & numerical data ; Oncology, Experimental ; Patients ; Race ; Retrospective Studies ; Retrospective study ; Robotics ; Social aspects ; Socioeconomic factors ; Surgeons ; Surgery ; Urbanization ; Variables ; Young Adult
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descriptionThe 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. 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. 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). 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. •National disparities in minimally invasive surgery (MIS) are well documented.•There is a paucity of state level data to corroborate or complement national findings.•Consistent with national studies, MIS for colorectal cancer in Florida is associated with insurance status and location.•Racial disparity for MIS in Florida differs by state regions. 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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abstractThe 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. 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. 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). 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. •National disparities in minimally invasive surgery (MIS) are well documented.•There is a paucity of state level data to corroborate or complement national findings.•Consistent with national studies, MIS for colorectal cancer in Florida is associated with insurance status and location.•Racial disparity for MIS in Florida differs by state regions. 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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