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.
|Young vs. old||1.33||1.27-1.39*|
Female vs. male
Caucasian vs. Other
|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