Ethnic Disparities in Use of Bariatric Surgery in the USA: the Experience of Native Americans.
American Indians
Bariatric surgery
Ethnic groups
Health expenditure
Insurance
Length of stay
Obesity
Journal
Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
pubmed:
20
3
2020
medline:
15
4
2021
entrez:
20
3
2020
Statut:
ppublish
Résumé
To examine disparities in use of bariatric surgery in the USA with particular focus on the experience of Native Americans. Multivariable logistic regression models were applied to the hospital discharge HCUP-NIS dataset (2008-2016) in order to examine the influence of ethnicity in use of bariatric surgery while controlling for aspects of need, predisposing and enabling factors. Separate models investigated disparities in length of stay, cost and discharge to healthcare facility among patient episodes for bariatric surgery. Full data for 1,729,245 bariatric surgery eligible participants were extracted from HCUP-NIS. The odds of Native Americans receiving bariatric surgery compared to White Americans were 0.67 (95% CI, 0.62-0.73) in a model unadjusted for covariates; 0.65 (95% CI, 0.59-0.71) in a model adjusted for demography and insurance; 0.59 (95% CI, 0.54-0.64) in a model adjusted for clinical variables; and 0.72 (95% CI, 0.66-0.79) in a model adjusted for demographic, insurance types and clinical variables. Native Americans who underwent surgery had significantly shorter lengths of stay, lower healthcare expenditures and lower likelihood of discharge to other healthcare facilities relative to White Americans (controlling for covariates). Our study, the first study to examine this subject, showed apparent variations in receipt of bariatric surgery between Native Americans and White Americans even after a range of covariates were controlled. In addition, Native Americans have shorter lengths of stay and significantly lower expenditures.
Identifiants
pubmed: 32189129
doi: 10.1007/s11695-020-04529-w
pii: 10.1007/s11695-020-04529-w
pmc: PMC7260278
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2612-2619Subventions
Organisme : Medical Research Council
ID : MR/K023241/1
Pays : United Kingdom
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