Hospital type affects racial disparities

Minority patients' health outcomes are affected by the type of hospital -- community, children's or county -- where they receive care, U.S. researchers say. Study author Dr. Stephen Shew, associate professor of surgery at the University of California, Los Angeles, Medical Center, and a pediatric surgeon at Mattel Children's hospital, said appendicitis is the most common reason for emergency abdominal surgery in children. The inflamed appendix can sometimes become perforated if the condition is not treated in a timely fashion -- usually one to two days from the time symptoms first appear -- and researchers have used appendix perforation as a marker for inadequate access to healthcare, Shew said. Existing research showed a number of factors such as age, socioeconomic status and the distance a family lives from a hospital, increase the risk for developing a perforated appendix in minorities. However, these factors don't tell the whole story, Shew said. The analysis involved 107,727 children ages 2-18 who were treated for appendicitis at 386 California hospitals between 1999 and 2007. Fifty-three percent were Hispanic, 36 percent were white, 3 percent were black, 5 percent were Asian, and 8 percent were of an unknown race. The study, published in Journal of American College of Surgeons, found Hispanic children were 23 percent more likely than white children to experience appendix perforation at community hospitals. Asian children were 34 percent more likely than white children to experience appendix perforation, and Hispanic patients treated at children's hospitals were 18 percent more likely than white patients to develop the complication.