Rates of surgical consultations for Black vs White patients after ED admission

Editor's Note

In this study from the University of Pennsylvania, Philadelphia, researchers find that Black Medicare patients were less likely to receive surgical consultations than White Medicare patients after being admitted from the emergency department (ED) with an emergency general surgery condition.

Of 1,686,940 Medicare patients included in the analysis, 214,788 (12.7%) were Black and 1,472,152 (87.3%) were White.

After standardizing for:

• medical and diagnostic imaging covariates, Black patients had 14% lower odds of receiving a surgical consultation than White patients, with a risk difference of -3.17
• socioeconomic covariates, Black patients had 11% lower odds of receiving a surgical consultation, with a risk difference of -2.49
• treatment in the same hospital, Blacks had 8% lower odds of receiving a surgical consultation, with a risk difference of -1.82.

The results highlight that unequal access to surgical care cannot be fully attributed to medical comorbidities, insurance status, socioeconomic factors, or hospital-level effects, the authors say. The medical community must further investigate the underlying reasons for the disparities and their impact on surgical outcomes.