National Healthcare Quality and Disparities Report
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- Cancer (1)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 12 of 12 Research Studies DisplayedMarcaccio CL, Patel PB, de Guerre L
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
The purpose of this study was to identify variations in 5-year outcomes and imaging surveillance after elective endovascular aortic aneurysm repair (EVAR) by sex, race, and ethnicity and to examine possible mechanisms contributing to these variations. The primary outcome was 5-year aneurysm rupture. Secondary outcomes were 5-year reintervention and mortality, and having no aortic imaging follow-up from 6 to 24 months after EVAR. The study found that among 16,040 patients, 73% were White males, 18% were White females, 2.6% were Black males, 1.1% were Black females, 0.9% were Asian males, 0.2% were Asian females, 1.7% were Hispanic males, and 0.4% were Hispanic females. At 5 years, Black females had the highest rupture rates at 6.4% and white males had the lowest at 2.3%. Compared with White males, rupture rates were higher in White females, Black females, and Asian females. Among other groups, Black males had higher reintervention and both Black and Hispanic males had higher rates of no imaging follow-up. In adjusted analyses, White, Black, and Asian females remained at significantly higher risk for 5-year rupture. The researchers concluded that Black females had higher 5-year aneurysm rupture, reintervention, and mortality rates after elective EVAR as compared with White male patients, whereas White females had higher rupture, mortality and loss-to-imaging-follow-up compared to White male patients. Black males had higher reintervention and no imaging follow-up, and Asian females had higher rupture rates.
AHRQ-funded; HS027285.
Citation: Marcaccio CL, Patel PB, de Guerre L .
Disparities in 5-year outcomes and imaging surveillance following elective endovascular repair of abdominal aortic aneurysm by sex, race, and ethnicity.
J Vasc Surg 2022 Nov;76(5):1205-15.e4. doi: 10.1016/j.jvs.2022.03.886..
Keywords: Disparities, Racial and Ethnic Minorities, Sex Factors, Outcomes, Imaging, Heart Disease and Health, Cardiovascular Conditions
Anjorin AC, Marcaccio CL, Patel PB
Racial and ethnic disparities in 3-year outcomes following infrainguinal bypass for chronic limb-threatening ischemia.
This study’s objective was to determine the differences in 3-year outcomes after open infrainguinal bypass for chronic limb-threatening ischemia (CLTI) stratified by race/ethnicity and explored the potential factors contributing to these differences to help determine reasons why outcomes are worse for racial and ethnic minorities. The authors identified all CLTI patients who had undergone primary open infrainguinal bypass in the Vascular Quality Initiative registry from 2003 to 2017 with linkage to Medicare claims through 2018 for the 3-year outcomes. Primary outcomes were the 3-year rates of major amputation, reintervention, and mortality. They also recorded 30-day major adverse limb events (MALE) defined as major amputation or reintervention. Of the 7108 patients with CLTI 79% were non-Hispanic White, 15% were Black, 1% were Asian, and 6% were Hispanic. Compared with White patients, Black patients had higher rates of 3-year major amputation (Black vs White, 32% vs 19%), reintervention (Black vs White, 61% vs 57%), and 30-day MALE (Black vs White, 8.1% vs 4.9%) but lower mortality (Black vs White, 38% vs 42%). Hispanic patients also experienced higher rates of amputation (Hispanic vs White, 27% vs 19%), reintervention (Hispanic vs White, 70% vs 57%), and MALE (Hispanic vs White, 8.7% vs 4.9%). However, mortality was similar between Hispanic vs White groups. A higher presence of comorbidities in Black and Hispanic patients with CLTI is considered the greatest contributing factors to higher amputation and reintervention rates.
AHRQ-funded; HS027285.
Citation: Anjorin AC, Marcaccio CL, Patel PB .
Racial and ethnic disparities in 3-year outcomes following infrainguinal bypass for chronic limb-threatening ischemia.
J Vasc Surg 2022 Nov;76(5):1335-46.e7. doi: 10.1016/j.jvs.2022.06.026..
Keywords: Racial and Ethnic Minorities, Disparities, Outcomes, Surgery, Cardiovascular Conditions
Song Zhang, Zhang X, Patterson LJ
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
This study assessed assess racial and ethnic differences in hospitalization outcomes during the COVID-19 pandemic among Medicare beneficiaries. Medicare claims from the Social Security Administration was used to determine in-hospital mortality and mortality inclusive of discharges to hospice and discharges to postacute care. Over 31 million Medicare recipients in the database were analyzed with over 14 million hospitalizations from January 2019 to February 2021. There was a decline in non-COVID-19 and an emergence of COVID-19 hospitalizations among beneficiaries of different racial and ethnic minority groups through February 2021. In-hospital mortality was not significantly different among Black patients relative to White patients but was 3.5 percentage points higher among Hispanic patients and other racial and ethnic minority groups. There were disparities in discharges to hospice and postacute care as well.
AHRQ-funded; HS024072.
Citation: Song Zhang, Zhang X, Patterson LJ .
Racial and ethnic disparities in hospitalization outcomes among Medicare beneficiaries during the COVID-19 pandemic.
JAMA Health Forum 2021 Dec 23;2(12):e214223. doi: 10.1001/jamahealthforum.2021.4223..
Keywords: COVID-19, Racial and Ethnic Minorities, Disparities, Medicare, Hospitalization, Outcomes, Mortality
Vervoort D, Canner JK, Haut ER
Racial disparities associated with reinterventions after elective endovascular aortic aneurysm repair.
In this study, the authors’ goal was to examine racial disparities associated with reinterventions following elective endovascular abdominal aortic aneurysm repair (EVAR) in a real-world cohort. Using the Vascular Quality Initiative EVAR dataset, they found that Black patients requiring reintervention were more frequently female, more frequently current or former smokers, and less frequently insured by Medicare/Medicaid. After adjusting for baseline differences, the risk of reintervention after elective EVAR was significantly lower for Black versus White patients, and all-cause mortality was comparable between groups. The authors recommended further investigation.
AHRQ-funded; HS024547.
Citation: Vervoort D, Canner JK, Haut ER .
Racial disparities associated with reinterventions after elective endovascular aortic aneurysm repair.
J Surg Res 2021 Dec;268:381-88. doi: 10.1016/j.jss.2021.07.010..
Keywords: Racial and Ethnic Minorities, Disparities, Outcomes
Dos Santos Marques IC, Theiss LM, Wood LN
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
The authors hypothesized that racial disparities exist for Hispanic and Asian patients undergoing surgery for inflammatory bowel disease (IBD). Data from the American College of Surgeons National Surgical Quality Improvement Program (ACS- NSQIP) was used. They found that racial disparities do exist among IBD patients undergoing surgery. Black, Hispanic, and Asian IBD patients experience major disparities in post-operative complications, readmissions, and length of stay, respectively, when compared to White patients with IBD. They recommended future research to better understand the mechanisms of these disparities including evaluation of social determinants of health.
AHRQ-funded; HS023009.
Citation: Dos Santos Marques IC, Theiss LM, Wood LN .
Racial disparities exist in surgical outcomes for patients with inflammatory bowel disease.
Am J Surg 2021 Apr;221(4):668-74. doi: 10.1016/j.amjsurg.2020.12.010..
Keywords: Disparities, Racial and Ethnic Minorities, Surgery, Digestive Disease and Health, Outcomes
Su CM, Warren A, Kraus C
Lack of racial and ethnic-based differences in acute care delivery in intracerebral hemorrhage.
Int J Emerg Med 2021 Jan 19;14(1):6. doi: 10.1186/s12245-021-00329-w.
Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. In this study the investigators examined whether racial or ethnic disparities existed in acute care processes in the first hours after ICH. The investigators found no evidence of racial/ethnic disparities in acute care processes or outcomes in ICH. English as first language, however, was associated with slower care processes.
Early diagnosis and treatment of intracerebral hemorrhage (ICH) is thought to be critical for improving outcomes. In this study the investigators examined whether racial or ethnic disparities existed in acute care processes in the first hours after ICH. The investigators found no evidence of racial/ethnic disparities in acute care processes or outcomes in ICH. English as first language, however, was associated with slower care processes.
AHRQ-funded; HS024561.
Citation: Su CM, Warren A, Kraus C .
Lack of racial and ethnic-based differences in acute care delivery in intracerebral hemorrhage.
Int J Emerg Med 2021 Jan 19;14(1):6. doi: 10.1186/s12245-021-00329-w..
Keywords: Racial and Ethnic Minorities, Disparities, Critical Care, Stroke, Cardiovascular Conditions, Outcomes
Gordon BE, Basak R, Carpenter WR
Factors influencing prostate cancer treatment decisions for African American and white men.
This prospective, population-based cohort study examined some possible reasons for mortality outcome differences for prostate cancer between African American (AA) and white patients. A cohort of 1170 men with nonmetastatic prostate cancer were enrolled from 2011 to 2013 before treatment in North Carolina. Participants were asked to rate their aggressiveness of their cancer, and also the importance of 10 factors their treatment decision-making process. Among low-risk patients, there was no difference in perception of their cancer as “not very aggressive”. Among high-risk patients, 54% of AA patients considered their cancer to be “not very aggressive” while only 24% of white patients did. For AA patients, cost, treatment time, and recovery time were considered very important more than white patients.
AHRQ-funded.
Citation: Gordon BE, Basak R, Carpenter WR .
Factors influencing prostate cancer treatment decisions for African American and white men.
Cancer 2019 May 15;125(10):1693-700. doi: 10.1002/cncr.31932..
Keywords: Decision Making, Cancer, Cancer: Prostate Cancer, Disparities, Men's Health, Outcomes, Patient-Centered Outcomes Research, Racial and Ethnic Minorities
Wahl TS, Goss LE, Morris MS
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
The purpose of this study was to investigate the effects of enhanced recovery after surgery (ERAS) on racial disparities in postoperative length of stay (pLOS) after colorectal surgery. The authors hypothesized that ERAS would reduce disparities in pLOS between black and white patients. They concluded that ERAS eliminated racial differences in pLOS between black and white patients undergoing colorectal surgery. Reduced pLOS occurred without increases in mortality, readmissions, and most postoperative complications.
AHRQ-funded; HS013852.
Citation: Wahl TS, Goss LE, Morris MS .
Enhanced Recovery After Surgery (ERAS) eliminates racial disparities in postoperative length of stay after colorectal surgery.
Ann Surg 2018 Dec;268(6):1026-35. doi: 10.1097/sla.0000000000002307..
Keywords: Surgery, Racial and Ethnic Minorities, Disparities, Care Management, Healthcare Delivery, Hospitalization, Patient-Centered Outcomes Research, Outcomes
Cole MB, Wright B, Wilson IB
Longitudinal analysis of racial/ethnic trends in quality outcomes in community health centers, 2009-2014.
The purpose of this study was to evaluate racial/ethnic time trends in quality outcomes in health centers and to assess both within- and between-center disparities in outcomes. The authors found that within- and between-center racial/ethnic disparities in quality were evident and although quality outcomes in health centers continued to compare favorably to other care settings, there was no evidence of improved quality or reduced disparities in diabetes control, hypertension control, or birthweight from 2009 to 2014.
AHRQ-funded; HS024652.
Citation: Cole MB, Wright B, Wilson IB .
Longitudinal analysis of racial/ethnic trends in quality outcomes in community health centers, 2009-2014.
J Gen Intern Med 2018 Jun;33(6):906-13. doi: 10.1007/s11606-018-4305-1..
Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities
Chhatre S, Jayadevappa R
Racial and ethnic disparities in substance use disorders and outcomes in elderly prostate cancer patients.
This study used Surveillance, Epidemiology, and End Results (SEER)-Medicare linked data to identify prevalence of substance use among patients with advanced-stage prostate cancer. There are racial and ethnic disparities between substance use and outcomes. A multidisciplinary coordinated care approach is recommended to address these disparities.
AHRQ-funded; HS024106.
Citation: Chhatre S, Jayadevappa R .
Racial and ethnic disparities in substance use disorders and outcomes in elderly prostate cancer patients.
J Ethn Subst Abuse 2018 Apr-Jun;17(2):135-49. doi: 10.1080/15332640.2016.1160019..
Keywords: Cancer: Prostate Cancer, Disparities, Elderly, Outcomes, Racial and Ethnic Minorities, Substance Abuse
Adelani MA, Keller MR, Barrack RL
The impact of hospital volume on racial differences in complications, readmissions, and emergency department visits following total joint arthroplasty.
This study evaluates the impact of hospital volume on racial differences in outcomes following joint replacement. The study authors concluded that adjusting for hospital volume does not alter the risk of readmissions and ED use associated with minority race/ethnicity, suggesting that hospital volume alone may be insufficient to explain racial differences in outcome.
AHRQ-funded; HS019455.
Citation: Adelani MA, Keller MR, Barrack RL .
The impact of hospital volume on racial differences in complications, readmissions, and emergency department visits following total joint arthroplasty.
J Arthroplasty 2018 Feb;33(2):309-15.e20. doi: 10.1016/j.arth.2017.09.034..
Keywords: Disparities, Healthcare Cost and Utilization Project (HCUP), Racial and Ethnic Minorities, Outcomes, Surgery
Cole MB, Wilson IB, Trivedi AN
State variation in quality outcomes and disparities in outcomes in community health centers.
The researchers estimated between-state variation in hypertension, diabetes, and pregnancy outcomes and racial/ethnic disparities in these outcomes for health center patients. They found wide variation in both outcomes and racial/ethnic disparities in outcomes between states for patients seen at health centers..
AHRQ-funded; HS024652.
Citation: Cole MB, Wilson IB, Trivedi AN .
State variation in quality outcomes and disparities in outcomes in community health centers.
Med Care 2017 Dec;55(12):1001-07. doi: 10.1097/mlr.0000000000000818.
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Keywords: Community-Based Practice, Disparities, Quality of Care, Outcomes, Racial and Ethnic Minorities