American journal of surgery
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We sought to identify differences among black and white Medicare-insured patients with colorectal cancer who underwent resection. ⋯ Black patients with colorectal cancer demonstrated increased risk of mortality and readmission after controlling for age, sex, and comorbidities. Although black vs white differences in perioperative mortality decreased over time, disparities in readmission and long-term survival persisted.
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Comparative Study
Disparities in trauma care: are fewer diagnostic tests conducted for uninsured patients with pelvic fracture?
Research from other medical specialties suggests that uninsured patients experience treatment delays, receive fewer diagnostic tests, and have reduced health literacy when compared with their insured counterparts. We hypothesized that these disparities in interventions would not be present among patients experiencing trauma. Our objective was to examine differences in diagnostic and therapeutic procedures administered to patients undergoing trauma with pelvic fractures using a national database. ⋯ Uninsured patients with pelvic fractures get fewer diagnostic procedures compared with their insured counterparts; this disparity is much greater for more invasive and resource-intensive tests and is less apparent in level 1 trauma centers. Differences in care that patients receive after trauma may be 1 of the mechanisms that leads to insurance disparities in outcomes after trauma.
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Black women can have worse outcomes than white women with breast cancer. We examined survival in black and white women who received neoadjuvant chemotherapy. ⋯ The pretreatment characteristics of women receiving neoadjuvant chemotherapy were similar. Black women had a worse disease-free survival. The overall survival was the same.
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Performance feedback or debriefing in surgery is increasingly recognized as an essential means to optimize learning in the operating room (OR). However, there is a lack of evidence regarding the current practice and barriers to debriefing in the OR. ⋯ There is a disparity between what the surgical community views as effective debriefing and actual debriefing practices in the OR. Improvements to the current debriefing culture and practice within the field of surgery should be considered to facilitate learning from clinical practice.