TY - JOUR
T1 - Do race, gender, and source of payment impact on anesthetic technique for inguinal hernia repair?
AU - Memtsoudis, Stavros G.
AU - Besculides, Melanie C.
AU - Swamidoss, Cephas P.
PY - 2006/8
Y1 - 2006/8
N2 - Study Objective: To evaluate the potential differences in the type of anesthesia provided to patients of different race, gender, and source of payment undergoing inguinal hernia repair (IHR). Design: Retrospective cohort study. Setting: Ambulatory surgical centers/National Survey of Ambulatory Surgery. Patients: 5810 patients older than 14 years who underwent IHR in an ambulatory surgical center. Interventions: Inguinal hernia repair under different types of anesthesia. Measurements: The association of race, gender, and source of payment with different types of anesthesia for IHR as determined by multivariate regression analysis. Results: Significant discrepancies in the use of various anesthetics between patients of different race, gender, and source of payment were found. Patients identified as black and those of other minority groups were significantly more likely to receive general anesthesia compared with those identified as white (odds ratio [OR] 2.76, confidence interval [CI] 1.96-3.88 and OR 1.66, CI 1.14-2.42, respectively). Those identified as black were less likely to receive epidural anesthesia compared with their white counterparts (OR 0.36, CI 0.14-0.95). Women were less likely than men to undergo IHR with epidural anesthesia (OR 0.5, 95% CI 0.3-0.85). Conclusion: Significant discrepancies in the use of various anesthetics for IHR between patients of different race, gender, and insurance status were found. Despite limitations inherent to secondary data analysis, the findings raise the possibility that nonmedical factors may influence anesthetic management.
AB - Study Objective: To evaluate the potential differences in the type of anesthesia provided to patients of different race, gender, and source of payment undergoing inguinal hernia repair (IHR). Design: Retrospective cohort study. Setting: Ambulatory surgical centers/National Survey of Ambulatory Surgery. Patients: 5810 patients older than 14 years who underwent IHR in an ambulatory surgical center. Interventions: Inguinal hernia repair under different types of anesthesia. Measurements: The association of race, gender, and source of payment with different types of anesthesia for IHR as determined by multivariate regression analysis. Results: Significant discrepancies in the use of various anesthetics between patients of different race, gender, and source of payment were found. Patients identified as black and those of other minority groups were significantly more likely to receive general anesthesia compared with those identified as white (odds ratio [OR] 2.76, confidence interval [CI] 1.96-3.88 and OR 1.66, CI 1.14-2.42, respectively). Those identified as black were less likely to receive epidural anesthesia compared with their white counterparts (OR 0.36, CI 0.14-0.95). Women were less likely than men to undergo IHR with epidural anesthesia (OR 0.5, 95% CI 0.3-0.85). Conclusion: Significant discrepancies in the use of various anesthetics for IHR between patients of different race, gender, and insurance status were found. Despite limitations inherent to secondary data analysis, the findings raise the possibility that nonmedical factors may influence anesthetic management.
KW - Anesthesia type
KW - Disparities
KW - Medical care
KW - Race
KW - Sex
UR - http://www.scopus.com/inward/record.url?scp=33746787750&partnerID=8YFLogxK
U2 - 10.1016/j.jclinane.2005.08.006
DO - 10.1016/j.jclinane.2005.08.006
M3 - Article
C2 - 16905076
AN - SCOPUS:33746787750
SN - 0952-8180
VL - 18
SP - 328
EP - 333
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
IS - 5
ER -