Rates of surgical consults lower for Black patients

Black Medicare patients have lower odds of receiving a surgical consultation after being admitted from the emergency department with an emergency general surgery condition versus similar White Medicare patients, according to a study published online Oct. 12 in JAMA Surgery.

Sanford E. Roberts, M.D., from the University of Pennsylvania in Philadelphia, and colleagues assessed whether Black Medicare patients (214,788 individuals) have similar rates of surgical consultations versus White Medicare patients (1,472,152 individuals) after being admitted from the emergency department (July 1, 2015, to June 30, 2018) with an emergency general surgery condition (colorectal, general abdominal, hepatopancreatobiliary, intestinal obstruction, and upper gastrointestinal).

The researchers found that when adjusting for medical and diagnostic imaging covariates, Black patients had lower odds of receiving a surgical consultation (odds ratio, 0.86). Odds remained lower for Black patients after standardizing for socioeconomic covariates (odds ratio, 0.89). Even for patients treated at the same hospital, Black patients had lower odds of receiving a surgical consultation when compared with White patients (odds ratio, 0.92).

"These disparities in consultation rates cannot be fully attributed to medical comorbidities, insurance status, socioeconomic factors, or individual hospital-level effects," the authors write.