title: Racial disparities in the use of laparoscopic surgery to treat colonic diverticulitis Are not fully explained by socioeconomics or disease complexity.
abstract: BACKGROUND
  Several studies have demonstrated favorable outcomes for laparoscopic surgery over open surgery for the treatment of diverticular disease. This study was designed to analyze the relationship between race, socioeconomic status and the use of laparoscopy to address diverticulitis.
  
  
  METHODS
  A retrospective analysis of 53,054 diverticulitis admissions was performed using data from the 2009-2013 National Inpatient Sample (NIS). The primary outcome was the use of laparoscopic versus open colectomy. Bivariate analysis and multivariable logistic regression were used to determine the raw and adjusted odds by race, insurance status, and median household income.
  
  
  RESULTS
  Overall, 41.6% of colectomies involved the use of laparoscopy. Black patients were 19% less likely than White patients to undergo laparoscopic surgery. Hispanic patients were no more or less likely to undergo laparoscopic colectomy. Lacking private insurance was a strong predictor of undergoing open surgery. Lower income patients were 33% less likely to receive minimally invasive colectomies.
  
  
  CONCLUSIONS
  These results demonstrate disparities in surgical treatment. Further research is warranted to understand and ameliorate treatment differences which can contribute to outcome disparities.
authors.affiliation: Department of Surgery, Augusta University, 1120 15th St, Augusta, GA 30912, USA. Electronic address: rlassiter@augusta.edu.
authors.forename: Randi L
authors.initials: RL
authors.lastname: Lassiter
authors.affiliation: Department of Surgery, Augusta University, 1120 15th St, Augusta, GA 30912, USA. Electronic address: atalukder@augusta.edu.
authors.forename: Asif
authors.initials: A
authors.lastname: Talukder
authors.affiliation: Department of Surgery, Augusta University, 1120 15th St, Augusta, GA 30912, USA. Electronic address: meabrams@augusta.edu.
authors.forename: Meryl M
authors.initials: MM
authors.lastname: Abrams
authors.affiliation: Department of Surgery, Augusta University, 1120 15th St, Augusta, GA 30912, USA. Electronic address: badam@augusta.edu.
authors.forename: Bao-Ling
authors.initials: BL
authors.lastname: Adam
authors.affiliation: Department of Surgery, Augusta University, 1120 15th St, Augusta, GA 30912, USA. Electronic address: dalbo@augusta.edu.
authors.forename: Daniel
authors.initials: D
authors.lastname: Albo
authors.affiliation: Department of Surgery, Augusta University, 1120 15th St, Augusta, GA 30912, USA. Electronic address: caswhite@augusta.edu.
authors.forename: Cassandra Q
authors.initials: CQ
authors.lastname: White
mesh_terms: D001741:Black or African American; D003082:Colectomy / Q000379:methods*; D004239:Diverticulitis, Colonic / Q000601:surgery*; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007182:Income; D019458:Insurance Coverage; D010535:Laparoscopy / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014481:United States; D044465:White People
keywords: Colectomy; Disparities; Diverticulitis; Laparoscopy; Minimally invasive surgery; Race; Socioeconomic status