Black and Hispanic Medicare patients with hip fracture wait longer for surgery than white patients
Research Activities, November 2010, No. 363
Delayed surgery after admission to the hospital for hip fracture is linked to subsequent complications ranging from pressure sores to sometimes life-threatening blood clots. Black and Hispanic Medicare patients with hip fractures experienced approximately a half-day delay in obtaining hip stabilization surgery compared with white patients, according to a team of researchers from the University of Texas and the University of South Alabama. The mean number of days to surgery was 1.2 for non-Hispanic whites, 1.6 for blacks, and 1.7 for Hispanics.
The complications following delayed hip surgery may be related to the longer period of immobilization brought about by the delay. In the majority of cases, the delay of stabilization surgery is due to the need to evaluate and stabilize such medical problems as chest pain and hypertension. One explanation for the longer preoperative time might be that preoperative management took longer for minorities because of the higher prevalence in blacks and Hispanics of undiagnosed and uncontrolled medical conditions such as diabetes and hypertension. Minority patients may need better access to primary care providers who could diagnose and manage these and other medical problems. Another possible explanation is delayed transportation to the hospital that could lead to an afternoon admission and surgery deferred to the next day, note the researchers.
Included in the study were 40,321 Medicare patients receiving hip surgery between 2001 and 2005. This study was supported in part by the Agency for Healthcare Research and Quality (HS11618).
See "The impact of race/ethnicity on preoperative time to hip stabilization procedure after hip fracture" by Tracy U. Nguyen-Oghalai, M.D., Ph.D., Yong-fang Kuo, Ph.D., Helen Wu, Ph.D., and others in the Southern Medical Journal 103(5), pp. 414-418.