Osayande Osagiede1, Aaron C Spaulding2, Jordan J Cochuyt2, James M Naessens2, Amit Merchea1, Pashtoon M Kasi3, Marie Crandall4, Dorin T Colibaseanu5. 1. Department of Surgery, Mayo Clinic, Jacksonville, FL, USA. 2. Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, USA. 3. Department of Medical Oncology, Mayo Clinic, Jacksonville, FL, USA. 4. Department of Surgery, University of Florida, Jacksonville, FL, USA. 5. Department of Surgery, Mayo Clinic, Jacksonville, FL, USA. Electronic address: Colibaseanu.dorin@mayo.edu.
Abstract
BACKGROUND: The cost of minimally invasive surgery (MIS) raises potential for racial and social disparities. The aim of this study was to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer (CRC) in Florida. METHODS: Using the Florida Inpatient Discharge Dataset, we examined the clinical data of patients who underwent elective resections for CRC during 2013-2015. Multivariable analysis was performed to identify differences in gender, age, race, urbanization, region, insurance and clinical characteristics associated with the surgical approach. RESULTS: Of the 10,224 patients identified, 5308 (52%) had open surgery and 4916 (48%) had MIS. Females (p = 0.012), Medicare-insured patients (p = 0.001) and residents of South Florida were more likely to undergo MIS. Patients with Medicaid (p = 0.008), metastasis (p < 0.001) or 3-5 comorbidities (p = 0.004) had reduced likelihood of MIS. Hispanic patients in Southwest Florida had reduced likelihood of receiving MIS than whites (p < 0.017). Patients who underwent MIS had significantly reduced LOS (p < 0.001). CONCLUSIONS: Consistent with national studies, MIS for CRC in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparities in MIS for CRC in Florida.
BACKGROUND: The cost of minimally invasive surgery (MIS) raises potential for racial and social disparities. The aim of this study was to identify the racial, socioeconomic and geographic disparities associated with MIS for colorectal cancer (CRC) in Florida. METHODS: Using the Florida Inpatient Discharge Dataset, we examined the clinical data of patients who underwent elective resections for CRC during 2013-2015. Multivariable analysis was performed to identify differences in gender, age, race, urbanization, region, insurance and clinical characteristics associated with the surgical approach. RESULTS: Of the 10,224 patients identified, 5308 (52%) had open surgery and 4916 (48%) had MIS. Females (p = 0.012), Medicare-insured patients (p = 0.001) and residents of South Florida were more likely to undergo MIS. Patients with Medicaid (p = 0.008), metastasis (p < 0.001) or 3-5 comorbidities (p = 0.004) had reduced likelihood of MIS. Hispanic patients in Southwest Florida had reduced likelihood of receiving MIS than whites (p < 0.017). Patients who underwent MIS had significantly reduced LOS (p < 0.001). CONCLUSIONS: Consistent with national studies, MIS for CRC in Florida is associated with insurance status and geographic location. There are patient-level regional differences for racial disparities in MIS for CRC in Florida.
Authors: Aaron C Spaulding; Hanadi Hamadi; Osayande Osagiede; Riccardo Lemini; Jordan J Cochuyt; John Watson; James M Naessens; Dorin T Colibaseanu Journal: J Robot Surg Date: 2020-09-02
Authors: Riccardo Lemini; Iktej S Jabbal; Krystof Stanek; Shalmali R Borkar; Aaron C Spaulding; Scott R Kelley; Dorin T Colibaseanu Journal: BMC Surg Date: 2021-03-25 Impact factor: 2.102
Authors: Riccardo Lemini; Kristopher Attwood; Tariq Almerey; Jinny Gunn; Tamanie E Yeager; Alexandra W Elias; Kristin Partain; Matthew S Jorgensen; Wenyan Ji; Emmanuel M Gabriel; Dorin T Colibaseanu Journal: J Gastrointest Oncol Date: 2019-12