Format

Send to

Choose Destination
J Clin Anesth. 2017 Aug;40:55-61. doi: 10.1016/j.jclinane.2016.11.002.

The effect of race on postsurgical ambulatory medical follow-up among United States Veterans.

Author information

1
Department of Anesthesiology, Yale School of Medicine, 333 Cedar St, TMP-3, New Haven, CT 06520. Electronic address: robert.schonberger@yale.edu.
2
Department of Anesthesiology, Yale School of Medicine, 333 Cedar St, TMP-3, New Haven, CT 06520; Yale Center for Analytical Sciences, Yale School of Public Health, New Haven, CT 06520. Electronic address: feng.dai@yale.edu.
3
Department of Anesthesiology, Yale School of Medicine, 333 Cedar St, TMP-3, New Haven, CT 06520; Department of Emergency Medicine, Yale School of Medicine, New Haven, CT 06516; VA Connecticut Healthcare System, 950 Campbell Ave, West Haven, CT 06516. Electronic address: cynthia.brandt@yale.edu.
4
Department of Anesthesiology, Yale School of Medicine, 333 Cedar St, TMP-3, New Haven, CT 06520; Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06520. Electronic address: matthew.burg@yale.edu.

Abstract

STUDY OBJECTIVE:

To investigate the association between self-identified black or African American race and the presence of ambulatory internal medicine follow-up in the year after surgery. Our hypothesis was that among US Veterans who presented for surgery, black or African American race would be associated with a decreased likelihood to receive ambulatory internal medicine follow-up in the year after surgery.

DESIGN:

Retrospective observational.

SETTING:

All US Veterans Affairs hospitals.

PATIENTS:

A total of 236,200 Veterans undergoing surgery between 2006 and 2011 who were discharged within 10 days of surgery and survived the full 1-year exposure period.

INTERVENTIONS:

None.

MEASUREMENTS:

Attendance at an internal medicine follow-up appointment within 1 year after surgery.

MAIN RESULTS:

After controlling for year of surgery, age, age ≥65 years, sex, Hispanic ethnicity, and number of inpatient days, black or African American patients were 11% more likely to lack internal medicine follow-up after surgery (adjusted odds ratio, 1.11; 95% confidence interval, 1.06-1.16). When accounting for geographic region, this difference remained significant at the Bonferoni-corrected P < .007 level only in the Midwest United States where black or African American patients were 28% more likely to lack medical follow-up in the year after surgery (odds ratio, 1.28; 95% confidence interval, 1.16-1.42; P < .0001).

CONCLUSIONS:

The disparity in ambulatory medical follow-up following surgery among black or African American vs nonblack or non-African American Veterans in the Midwest region deserves further study and may lead to important quality improvement initiatives aimed specifically at this population.

PMID:
28625448
PMCID:
PMC5490668
DOI:
10.1016/j.jclinane.2016.11.002
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center