Skip to main content
Top
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Research

Patients undergoing colorectal surgery at a Veterans Affairs Hospital do not experience racial disparity in length of stay either before or after implementing an enhanced recovery pathway

Authors: C. Rentas, S. Baker, L. Goss, J. Richman, S. J. Knight, C. Key, M. Morris

Published in: BMC Surgery | Issue 1/2022

Login to get access

Abstract

Background

Enhanced Recovery Pathways (ERP) have been shown to reduce racial disparities following surgery. The objective of this study is to determine whether ERP implementation mitigates racial disparities at a Veterans Affairs Hospital.

Methods

A retrospective cohort study was conducted using data obtained from the Veterans Affairs Surgical Quality Improvement Program. All patients undergoing elective colorectal surgery following ERP implementation were included. Current procedural terminology (CPT) codes were used to identify patients who underwent similar procedures prior to ERP implementation.

Results

Our study included 417 patients (314 pre-ERP vs. 103 ERP), 97.1% of which were male, with an average age of 62.32 (interquartile range (IQR): 25–90). ERP patients overall had a significantly shorter post-operative length of stay (pLOS) vs. pre-ERP patients (median 4 days (IQR: 3–6.5) vs. 6 days (IQR: 4–9) days (p < 0.001)). Within the pre-ERP group, median pLOS for both races was 6 days (IQR: 4–6; p < 0.976) and both groups experienced a decrease in median pLOS (4 vs. 6 days; p < 0.009 and p < 0.001) following ERP implementation.

Conclusions

Racial disparities did not exist in patients undergoing elective surgery at a single VA Medical Center. Implementation of an ERP significantly reduced pLOS for black and white patients.
Appendix
Available only for authorised users
Literature
9.
go back to reference PAR-16-392. National Institutes of Health; 2019. PAR-16-392. National Institutes of Health; 2019.
15.
go back to reference Leeds L, Alimi Y, Hobson DR, et al. Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway. Dis Colon Rectum. 2017;60(10):1092–101.CrossRef Leeds L, Alimi Y, Hobson DR, et al. Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway. Dis Colon Rectum. 2017;60(10):1092–101.CrossRef
19.
go back to reference Veterans Affairs Surgical Quality Improvement Program (VASQIP). Updated 2 July 2019. Accessed 7 Feb 2020. Veterans Affairs Surgical Quality Improvement Program (VASQIP). Updated 2 July 2019. Accessed 7 Feb 2020.
26.
go back to reference Saha S, Freeman M, Toure J, Tippens KM, Weeks C. VA Evidence-based synthesis program reports. Racial and ethnic disparities in the VA healthcare system: a systematic review. Department of Veterans Affairs (US); 2007. Saha S, Freeman M, Toure J, Tippens KM, Weeks C. VA Evidence-based synthesis program reports. Racial and ethnic disparities in the VA healthcare system: a systematic review. Department of Veterans Affairs (US); 2007.
27.
go back to reference Landrum MB, Keating NL, Lamont EB, Bozeman SR, Krasnow SH, Shulman L, Brown JR, Earle CC, Rabin M, McNeil BJ. Survival of older patients with cancer in the Veterans Health Administration versus fee-for-service medicare. J Clin Oncol. 2012;10:1072–9.CrossRef Landrum MB, Keating NL, Lamont EB, Bozeman SR, Krasnow SH, Shulman L, Brown JR, Earle CC, Rabin M, McNeil BJ. Survival of older patients with cancer in the Veterans Health Administration versus fee-for-service medicare. J Clin Oncol. 2012;10:1072–9.CrossRef
Metadata
Title
Patients undergoing colorectal surgery at a Veterans Affairs Hospital do not experience racial disparity in length of stay either before or after implementing an enhanced recovery pathway
Authors
C. Rentas
S. Baker
L. Goss
J. Richman
S. J. Knight
C. Key
M. Morris
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01647-3

Other articles of this Issue 1/2022

BMC Surgery 1/2022 Go to the issue