Quality of Care for Women Undergoing a Hysterectomy: Effects of Insurance and Race/Ethnicity

Abstract

Increased complications after hysterectomy may result in increased economic burdens to Medicaid. Further studies of the racial/ethnic and sociodemographic issues are needed so that disparities may be adequately addressed.

Racial and Insurance Status Disparities in Patient Safety Indicators among Hospitalized Patients

“…Previous research indicates that minority patients are more likely to receive lower quality of care across a range of conditions and care processes, and have higher morbidity and mortality rates including some patient safety indicators on selected outcomes. [2][3][4][5][6][7][8][9][10][11][12][13] Patient safety indicators (PSIs), developed by the Agency for Healthcare Research and Quality (AHRQ), are a set of indicators providing information on potential in-hospital complications and adverse events following surgeries, procedures, and childbirth. The PSIs were developed after a comprehensive literature review, analysis of ICD-9-CM codes, review by a clinician panel, implementation of risk adjustment, and empirical analyses.…”

The impact of insurance status on outcomes after surgery for spinal metastases

“…[2][3][4] In addition, the number of Americans with government-sponsored insurance will increase, but some have expressed concern about the quality of care provided to Medicaid recipients, partially because of low physician reimbursmenet. 5 A growing body of literature suggests that Americans with suboptimal insurance are at risk for poor medical and surgical outcomes. 1, Disparities based on insurance status are well documented in oncology patients: restricted access to cancer screening, 11 poor postoperative outcomes after tumor resection, 19 limited ability to enroll in clinical trials, 8 and inferior survival 12,13,24 for patients with unfavorable insurance have been described for those with many different tumor types.…”

Are hysterectomies necessary? Racial-ethnic differences in women’s attitudes

“…The vast majority of hysterectomies are performed to eradicate benign conditions, such as fibroids or endometriosis, or to deal with troublesome menstrual symptoms such as heavy bleeding (Gibson et al, 2011). Some research suggests that women with hysterectomies experience earlier menopause and that women who experience hysterectomy plus the removal of both of their ovaries will experience immediate menopause (Hendrix, 2005), but we do not know much about the long-term physiological or psychosocial effects of these onsets of menopause or the complicated social contexts that surround surgical menopause (Hakim, Benedict, & Merrick, 2004;Gibson et al, 2011). Part of the gap in our knowledge is because, while social science scholars have conducted considerable research on women's experiences of natural menopause, they have neither sufficiently studied the experiences of women who reach this stage through surgery nor completed studies that compare the two groups.…”

“…Hakim et al (2004) propose that further study of the effects of race/ethnicity for women with hysterectomies is needed, as the effects of these social locations on menopausal women are real but only partially understood. In addition, it is well documented that the rates of hysterectomy vary across regional areas and racial-ethnic groups in the United States.…”