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More Blacks Die in Hospital After Diverticulitis Surgery

TUESDAY, Nov. 22 (HealthDay News) -- Elderly black patients who require surgery for an intestinal condition called diverticulitis are much more likely to die in the hospital than white patients, a new study has found.

This increased risk of death was present even when black patients had the same health insurance as white patients, the Johns Hopkins researchers found.

Diverticulitis occurs when small pouches in the lining of the intestine become infected or inflamed. It's a common gastrointestinal condition that affects up to 25 percent of elderly people. Surgery is required in severe cases.

In this study, the Hopkins team analyzed data from more than 50,000 Medicare patients who underwent surgery for diverticulitis between 2004 and 2007. They found that black patients were 28 percent more likely to die while in the hospital than white patients, regardless of whether they underwent planned or emergency surgery.

The researchers also found that black patients were 26 percent more likely than white patients to undergo riskier emergency surgery and spent more time in the hospital recovering from their operations. Hospital stays for black patients cost an average of nearly $30,000 more than for white patients.

The study is published in the November issue of the journal Archives of Surgery.

Lack of health insurance is often a major reason for racial disparities in health care but not in this case, the researchers noted.

"Even if everyone has coverage, black patients are doing worse, so we need to find out what else is going on. Maybe then we can make a difference," study leader Eric Schneider, an epidemiologist at the Johns Hopkins Center for Surgical Trials and Outcomes Research, said in a Hopkins news release.

Prior studies have found that blacks are less likely than whites to see a doctor, even when they have insurance. This may be because black patients have less trust in the medical establishment than whites, Schneider suggested in the news release.

"It may be an access issue. It may be a cultural issue," Schneider said. "Whites are more likely to have a family practitioner and that may be a factor."

Another expert agreed that more research is needed to pinpoint the cause of the disparity.

"The study does not offer an explanation for these findings. Understanding why these discrepancies exist is crucial to improving health care in this population," said Dr. David Bernstein, chief of the division of gastroenterology at North Shore University Hospital in Manhasset, N.Y.

"Based upon the data presented, one can only assume that the findings are either related to different racial characteristics or more likely to the availability of timely, outpatient care in this particular population," he added. "Further evaluation should be performed to better explain the findings in this important study."

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more about diverticulitis.

-- Robert Preidt

SOURCE: David Bernstein, M.D., chief, division of gastroenterology, North Shore University Hospital, Manhasset, N.Y.; Johns Hopkins Medicine, news release, Nov. 21, 2011

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