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Mass. Law Cut Race Gap for Certain Surgeries: Study

More blacks, Hispanics get less-invasive procedures for appendicitis, gallbladder since state health reform

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

WEDNESDAY, Oct. 2 (HealthDay News) -- Blacks and Hispanics in Massachusetts became more likely to have minimally invasive laparoscopic surgery on their appendix and gallbladder after the state's 2006 health care reforms expanded insurance coverage, a new study finds.

Laparoscopic surgery is the standard of care for appendicitis and inflammation of the gallbladder (cholecystitis). But lack of insurance and being a member of a racial/ethnic minority have both been associated with lower use of laparoscopic surgery for these conditions, according to background information in the study, published online Oct. 2 in the journal JAMA Surgery.

Researchers examined data from more than 167,000 people who were treated for appendicitis or cholecystitis at Massachusetts hospitals between 2001 and 2009, as well as data from six other states for comparison ("control states"): Arizona, Florida, Maryland, New Jersey, New York and Washington.

Before the state implemented health care reforms in 2006, nonwhite patients in Massachusetts were 5.2 percent less likely than whites to have laparoscopic surgery for the two conditions. Nonwhite patients in the control states were 1.4 percent less likely to have laparoscopic surgery.

After the 2006 health care reforms, nonwhite patients in Massachusetts were 0.06 percent less likely to have laparoscopic surgery than whites, while nonwhite patients in the control states were 3.2 percent less likely to have laparoscopic surgery.

The findings indicate that the racial disparity in laparoscopic surgery for appendicitis or cholecystitis disappeared in Massachusetts after the 2006 health care reforms, but persisted in other states, Dr. Andrew Loehrer, of Massachusetts General Hospital, and colleagues pointed out in a journal news release.

The findings are timely because the national health reform law, known as the Affordable Care Act, is currently making headlines as millions of Americans who have been unable to obtain or afford health insurance in the past are now starting to sign up for coverage. The Massachusetts health plan law was used, in part, as a model for the new federal law.

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