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Racial disparities in Medicaid patients after brain tumor surgery.

Publication ,  Journal Article
Mukherjee, D; Patil, CG; Todnem, N; Ugiliweneza, B; Nuño, M; Kinsman, M; Lad, SP; Boakye, M
Published in: J Clin Neurosci
January 2013

The presence of healthcare-related disparities is an ongoing, widespread, and well-documented societal and health policy issue. We investigated the presence of racial disparities among post-operative patients either with meningioma or malignant, benign, or metastatic brain tumors. We used the Medicaid component of the Thomson Reuter's MarketScan database from 2000 to 2009. Univariate and multivariate analysis assessed death, 30-day post-operative risk of complications, length of stay, and total charges. We identified 2321 patients, 73.7% were Caucasian, 57.8% were women; with Charlson comorbidity scores of <3 (56.2%) and treated at low-volume centers (73.4%). Among all, 26.3% of patients were of African-American ethnicity and 22.1% had meningiomas. Mortality was 2.0%, mean length of stay (LOS) was 9 days, mean total charges were US$42,422, an adverse discharge occurred in 22.5% of patients, and overall 30-day complication rate was 23.4%. In a multivariate analysis, African-American patients with meningiomas had higher odds of developing a 30-day complication (p=0.05) and were significantly more likely to have longer LOS (p<0.001) and greater total charges (p<0.001) relative to Caucasian counterparts. The presence of one post-operative complication doubled LOS and nearly doubled total charges, while the presence of two post-operative complications tripled these outcomes. Patients of African-American ethnicity had significantly higher post-operative complications than those of Caucasian ethnicity. This higher rate of complications seems to have driven greater healthcare utilization, including greater LOS and total charges, among African-American patients. Interventions aimed at reducing complications among African-American patients with brain tumor may help reduce post-operative disparities.

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Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

January 2013

Volume

20

Issue

1

Start / End Page

57 / 61

Location

Scotland

Related Subject Headings

  • White People
  • United States
  • Survival Rate
  • Statistics, Nonparametric
  • Socioeconomic Factors
  • Retrospective Studies
  • Postoperative Complications
  • Neurology & Neurosurgery
  • Multivariate Analysis
  • Middle Aged
 

Citation

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Mukherjee, D., Patil, C. G., Todnem, N., Ugiliweneza, B., Nuño, M., Kinsman, M., … Boakye, M. (2013). Racial disparities in Medicaid patients after brain tumor surgery. J Clin Neurosci, 20(1), 57–61. https://doi.org/10.1016/j.jocn.2012.05.014
Mukherjee, Debraj, Chirag G. Patil, Nathan Todnem, Beatrice Ugiliweneza, Miriam Nuño, Michael Kinsman, Shivanand P. Lad, and Maxwell Boakye. “Racial disparities in Medicaid patients after brain tumor surgery.J Clin Neurosci 20, no. 1 (January 2013): 57–61. https://doi.org/10.1016/j.jocn.2012.05.014.
Mukherjee D, Patil CG, Todnem N, Ugiliweneza B, Nuño M, Kinsman M, et al. Racial disparities in Medicaid patients after brain tumor surgery. J Clin Neurosci. 2013 Jan;20(1):57–61.
Mukherjee, Debraj, et al. “Racial disparities in Medicaid patients after brain tumor surgery.J Clin Neurosci, vol. 20, no. 1, Jan. 2013, pp. 57–61. Pubmed, doi:10.1016/j.jocn.2012.05.014.
Mukherjee D, Patil CG, Todnem N, Ugiliweneza B, Nuño M, Kinsman M, Lad SP, Boakye M. Racial disparities in Medicaid patients after brain tumor surgery. J Clin Neurosci. 2013 Jan;20(1):57–61.
Journal cover image

Published In

J Clin Neurosci

DOI

EISSN

1532-2653

Publication Date

January 2013

Volume

20

Issue

1

Start / End Page

57 / 61

Location

Scotland

Related Subject Headings

  • White People
  • United States
  • Survival Rate
  • Statistics, Nonparametric
  • Socioeconomic Factors
  • Retrospective Studies
  • Postoperative Complications
  • Neurology & Neurosurgery
  • Multivariate Analysis
  • Middle Aged