title: The effect of race and socioeconomic status on outcomes following adrenal operations.
abstract: BACKGROUND
  Disparities following different operations exist. We seek to measure the effects of race/ethnicity and socioeconomic status on outcomes following adrenal surgery.
  
  
  METHODS
  Cross-sectional analysis of adrenal operations identified in the Nationwide Inpatient Sample (NIS) from 2003 to 2009.
  
  
  RESULTS
  A total of 7,537 procedures were included. Operations by high-volume surgeons had shorter length of stay (LOS) (3.4 days vs. 5.2 days, P < 0.001) and fewer complications (11.6% vs. 16.7%, P < 0.001). Hispanics were more likely to be operated on by low-volume surgeons [OR: 2.17, 95%CI: (1.33, 3.55)]. There were significant differences in LOS and cost among races/ethnicities, income categories, and insurance types (P < 0.05). Hispanics had longer LOS compared to Whites (P = 0.002) and their management was associated with a higher cost ($20,754.00 ± 1,478.40). Patients with either Medicaid [OR: 1.70, 95%CI: (1.30, 2.22)] or Medicare [OR: 1.86, 95%CI: (1.36, 2.54)] were more likely to have a LOS >5 days.
  
  
  CONCLUSIONS
  Racial and socioeconomic disparities exist; however, they are not solely related to access. A complex interplay between various racial, cultural, and socioeconomic factors likely influence outcomes in adrenal surgery.
authors.affiliation: Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Adam
authors.initials: A
authors.lastname: Hauch
authors.affiliation: Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Zaid
authors.initials: Z
authors.lastname: Al-Qurayshi
authors.affiliation: Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors.forename: Emad
authors.initials: E
authors.lastname: Kandil
mesh_terms: D000315:Adrenalectomy / Q000706:statistics & numerical data*; D000328:Adult; D001741:Black or African American; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012923:Social Class; D014481:United States; D044465:White People
keywords: adrenalectomy; disparities; race; socioeconomic status