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Massachusetts Health Reform Reduced Racial Disparities

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Massachusetts Health Reform Reduced Racial Disparities

Following reform, whites, non-whites equally likely to have minimally invasive surgery

FRIDAY, Oct. 4 (HealthDay News) -- Following initiation of health care reform in Massachusetts in 2006, white and non-white patients have an equal probability of having minimally invasive surgery (MIS), according to a study published online Oct. 2 in JAMA Surgery.

Andrew P. Loehrer, M.D., from Massachusetts General Hospital in Boston, and colleagues retrospectively assessed the probability of undergoing MIS versus an open operation for non-white patients in Massachusetts compared with six control states. Data from the Hospital Cost and Utilization Project State Inpatient Databases identified all discharges (167,560) of non-elderly white, black, or Latino patients with government insurance (Medicaid or Commonwealth Care insurance) or no insurance who underwent an inpatient procedure for acute appendicitis or acute cholecystitis between 2001 and 2009.

The researchers found that, prior to 2006, non-white patients had a significantly lower probability of MIS relative to white patients, both within Massachusetts and in control states. Non-white patients in Massachusetts after reform had a 3.71 percentage point increase in the probability of MIS relative to parallel trends in control states (P = 0.01). After 2006, measured racial disparities in MIS resolved in Massachusetts. In control states without reform, non-white patients were found to have a persistently significantly lower probability of MIS relative to white patients.

"The 2006 Massachusetts insurance expansion was associated with an increased probability of nonwhite patients undergoing MIS and resolution of measured racial disparities in MIS," the authors write.

Abstract (http://archsurg.jamanetwork.com/article.aspx?articleid=1744442#Abstract )Full Text (subscription or payment may be required) (http://archsurg.jamanetwork.com/article.aspx?articleid=1744442 )