Background: Laparoscopy is the standard approach for basic gastrointestinal procedures such appendectomy and cholecystectomy. We determined the disparities in access to basic laparoscopic surgeryat U.S. academiccenters.
Methods: A retrospective analysis of a large administrative, clinical, and financial database (University Health System Consortium) of US Academic Medical Centers was conducted.Using appropriate ICD-9-CM procedure codes and diagnosis we identified 112,540 laparoscopic (n=82,062; 72.9%) and open (n=30,478;27.1%) appendectomies and cholecystectomiesover a 4-year period (2005-2009). The odds ratio (OR) for laparoscopic vs. open procedures were calculated and stratified byage (< or ≥ 65 years), gender, race/ethnicity, admission status, severity of illness (surgery risk) and primary payer status.
Results:
Variables | OR | 95% CI |
Young vs. old | 1.33 | 1.27-1.39* |
Female vs. male |
1.79 | 1.75-1.84* |
Caucasian vs. Other |
1.07 | 1.03-1.11* |
Elective vs. emergent | 1.00 | 0.96-1.05 |
Low vs. high risk | 1.96 | 1.86-2.06* |
Private payer vs. Medicare | 1.25 | 1.21-1.29* |
95% CI = Confidence interval; *=p<.05 by Chi2
Conclusion:A young, Caucasian female who is low risk andhas private insurance is more likely to receive a laparoscopic approachforthe procedures studied.Disparities in access to basic laparoscopic surgeryexist at U.S. academic centers.
Session: Podium Presentation
Program Number: S015