2017
Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals
Hwang DY, George BP, Kelly AG, Schneider EB, Sheth KN, Holloway RG. Variability in Gastrostomy Tube Placement for Intracerebral Hemorrhage Patients at US Hospitals. Journal Of Stroke And Cerebrovascular Diseases 2017, 27: 978-987. PMID: 29221969, DOI: 10.1016/j.jstrokecerebrovasdis.2017.11.001.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overCerebral HemorrhageClinical Decision-MakingDatabases, FactualFemaleGastrostomyHealthcare DisparitiesHospitalsHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioPractice Patterns, Physicians'Process Assessment, Health CareRetrospective StudiesTime FactorsUnited StatesYoung AdultConceptsGastrostomy tube placementTube placementGastrostomy tubeICH patientsIntracerebral hemorrhageUS hospitalsMultilevel multivariable regression modelsHospital random effectsNationwide Inpatient SampleIntracerebral hemorrhage patientsMultivariable regression modelsLocal practice patternsMedian odds ratioICH hospitalizationsHospital factorsHospital covariatesRegression modelsHemorrhage patientsICH admissionsInpatient SampleOdds ratioPlacement ratesPractice patternsMedian increasePatientsImpact of the insurance type of head and neck cancer patients on their hospitalization utilization patterns
Gupta A, Sonis S, Schneider E, Villa A. Impact of the insurance type of head and neck cancer patients on their hospitalization utilization patterns. Cancer 2017, 124: 760-768. PMID: 29112234, DOI: 10.1002/cncr.31095.Peer-Reviewed Original ResearchConceptsHNC patientsHospital typeUninsured patientsInsurance typeMortality riskInsurance-related disparitiesInferior survival outcomesNationwide Inpatient SampleNeck cancer patientsLogistic regression modelsOptimum treatment outcomesMultinomial logistic regression modelsPatient agePoor outcomeSurvival outcomesPrimary exposureCancer patientsInpatient SampleHNC outcomesInpatient careTreatment outcomesHospital settingProvider typePatientsGovernment hospitals
2016
Race-based differences in duration of stay among universally insured coronary artery bypass graft patients in military versus civilian hospitals
Chowdhury R, Davis WA, Chaudhary MA, Jiang W, Zogg CK, Schoenfeld AJ, Jaklitsch MT, Kaneko T, Learn PA, Haider AH, Schneider EB. Race-based differences in duration of stay among universally insured coronary artery bypass graft patients in military versus civilian hospitals. Surgery 2016, 161: 1090-1099. PMID: 27932028, DOI: 10.1016/j.surg.2016.10.022.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBlack or African AmericanCohort StudiesConfidence IntervalsCoronary Artery BypassCoronary Artery DiseaseDatabases, FactualFemaleHealthcare DisparitiesHospital MortalityHospitals, MilitaryHospitals, PublicHumansLength of StayMaleMiddle AgedPrognosisRegression AnalysisRisk AssessmentSurvival AnalysisTreatment OutcomeUnited StatesUniversal Health InsuranceWhite PeopleConceptsCoronary artery bypass graftArtery bypass graftCoronary artery bypass graft patientsDuration of stayBypass graft patientsBypass graftRace-based differencesGraft patientsBlack patientsMilitary HospitalCivilian hospitalsHospital-level factorsEligible patientsWhite patientsMale patientsCivilian facilitiesWhite racePatientsStayTRICARE coverageNegative binomial regressionHospitalApparent mitigationGraftGreater durationDisparities in receipt of a laparoscopic operation for ectopic pregnancy among TRICARE beneficiaries
Ranjit A, Chaudhary MA, Jiang W, Zhan T, Schneider EB, Cohen SL, Little SE, Haider AH, Robinson JN, Witkop CT. Disparities in receipt of a laparoscopic operation for ectopic pregnancy among TRICARE beneficiaries. Surgery 2016, 161: 1341-1347. PMID: 27842916, DOI: 10.1016/j.surg.2016.09.029.Peer-Reviewed Original ResearchConceptsEctopic pregnancyLaparoscopic operationsRacial disparitiesWhite womenDays of diagnosisOdds of receiptRacial minority patientsSystems of careBlack womenTRICARE dataPatient demographicsUniversal insurance coverageMultivariable analysisTRICARE beneficiariesOperative approachMinority patientsPurchased careLesser oddsPregnancyDirect carePatientsAsian womenInsurance accessCareInsurance coverageImplementing Sexual Orientation and Gender Identity Data Collection in Emergency Departments: Patient and Staff Perspectives
German D, Kodadek L, Shields R, Peterson S, Snyder C, Schneider E, Vail L, Ranjit A, Torain M, Schuur J, Lau B, Haider A. Implementing Sexual Orientation and Gender Identity Data Collection in Emergency Departments: Patient and Staff Perspectives. LGBT Health 2016, 3: 416-423. PMID: 27792473, DOI: 10.1089/lgbt.2016.0069.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAttitude of Health PersonnelConfidentialityCulturally Competent CareData CollectionElectronic Health RecordsEmergency Medical ServicesEmergency Service, HospitalFemaleGender IdentityHealthcare DisparitiesHumansInterviews as TopicMaleMiddle AgedPatient-Centered CarePrivacySexual and Gender MinoritiesSexual BehaviorYoung AdultConceptsEmergency departmentGender identity data collectionProvider comfortED nursesGender identity informationPatientsPhysician assistantsHealth disparitiesPopulation healthProvider perspectivesStaff perspectivesSafe disclosureStandardized collectionConstant comparative methodPurposive sampleMultiple codersData collectionDiverse purposive sampleSexual orientationDepartmentCultural competency
2015
Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients
Shah AA, Zogg CK, Zafar SN, Schneider EB, Cooper LA, Chapital AB, Peterson SM, Havens JM, Thorpe RJ, Roter DL, Castillo RC, Salim A, Haider AH. Analgesic Access for Acute Abdominal Pain in the Emergency Department Among Racial/Ethnic Minority Patients. Medical Care 2015, 53: 1000-1009. PMID: 26569642, DOI: 10.1097/mlr.0000000000000444.Peer-Reviewed Original ResearchMeSH KeywordsAbdominal PainAcute PainAdolescentAdultAgedAnalgesicsBlack or African AmericanDiagnostic Techniques and ProceduresEmergency Service, HospitalEthnicityFemaleHealth Care SurveysHealthcare DisparitiesHispanic or LatinoHospitalizationHumansLength of StayMaleMiddle AgedNarcoticsRacial GroupsResidence CharacteristicsRetrospective StudiesSocioeconomic FactorsTime FactorsWhite PeopleYoung AdultConceptsAcute abdominal painLower risk-adjusted oddsRisk-adjusted oddsAbdominal painRace/ethnicityEmergency departmentMinority patientsEthnic disparitiesNontraumatic acute abdominal painRisk-adjusted multivariable analysisNon-Hispanic black patientsNon-Hispanic white patientsRace/ethnicity-based differencesEthnic group patientsModerate-severe painPatient-reported painPatients 18 yearsProportion of patientsSubsequent inpatient admissionSurgery of TraumaRisk-adjusted differencesED wait timesNon-Hispanic blacksEthnic minority patientsUniform definitionInsurance status and health-related quality-of-life disparities after trauma: results from a nationally representative survey in the US
Alghnam S, Schneider E, Castillo R. Insurance status and health-related quality-of-life disparities after trauma: results from a nationally representative survey in the US. Quality Of Life Research 2015, 25: 987-995. PMID: 26341970, DOI: 10.1007/s11136-015-1126-0.Peer-Reviewed Original ResearchConceptsPhysical component scoreMental component scoreVisual analog scaleHealth-related qualityMedical Expenditure Panel SurveyInsurance statusHealthcare utilizationEQ-5DSF-12 physical component scoreBaseline self-reported healthEuroQol health indexLower EQ-5DComponent scoresSelf-reported healthHospital dischargeLower HRQoLAdjusted analysisAnalog scaleResultsSeven hundredInjury statusObservational studyOutcome disparitiesStudy populationUS adultsUninsured individualsExplaining the Paradoxical Age-based Racial Disparities in Survival After Trauma
Hicks C, Hashmi Z, Hui X, Velopulos C, Efron D, Schneider E, Cooper L, Haut E, Cornwell E, Haider A. Explaining the Paradoxical Age-based Racial Disparities in Survival After Trauma. Annals Of Surgery 2015, 262: 179-183. PMID: 24979610, DOI: 10.1097/sla.0000000000000809.Peer-Reviewed Original ResearchConceptsOlder black patientsYoung black patientsYoung white patientsBlack patientsWhite patientsBlack trauma patientsRacial disparitiesTrauma patientsInjury severityClinical Modification diagnosis codesOlder white patientsPatients 65 yearsOverall injury severityMechanism of injuryNationwide Inpatient SampleHead injury severityOlder patientsIncreased oddsComorbid conditionsSurvival outcomesNinth RevisionInsurance statusAdjusted oddsDiagnosis codesInpatient SampleRacial/Ethnic Disparities Associated With Initial Hemodialysis Access
Zarkowsky DS, Arhuidese IJ, Hicks CW, Canner JK, Qazi U, Obeid T, Schneider E, Abularrage CJ, Freischlag JA, Malas MB. Racial/Ethnic Disparities Associated With Initial Hemodialysis Access. JAMA Surgery 2015, 150: 529-536. PMID: 25923973, DOI: 10.1001/jamasurg.2015.0287.Peer-Reviewed Original ResearchConceptsMedical insurance statusEnd-stage renal diseaseUS Renal Data SystemInitial hemodialysis accessWhite patientsArteriovenous fistulaBlack patientsHispanic patientsRace/ethnicityNephrology careInsurance statusRenal diseaseHemodialysis accessChronic obstructive pulmonary diseaseLogistic regressionMore white patientsInfluence of comorbiditiesObstructive pulmonary diseaseRacial/Ethnic DisparitiesCoronary artery diseaseCategory of patientsMultivariable logistic regressionPatterns of utilizationDifferent races/ethnicitiesFistula utilizationUnconscious Race and Social Class Bias Among Acute Care Surgical Clinicians and Clinical Treatment Decisions
Haider A, Schneider E, Sriram N, Dossick D, Scott V, Swoboda S, Losonczy L, Haut E, Efron D, Pronovost P, Lipsett P, Cornwell E, MacKenzie E, Cooper L, Freischlag J. Unconscious Race and Social Class Bias Among Acute Care Surgical Clinicians and Clinical Treatment Decisions. JAMA Surgery 2015, 150: 457-464. PMID: 25786199, DOI: 10.1001/jamasurg.2014.4038.Peer-Reviewed Original ResearchConceptsClinical decisionMultivariable analysisUnconscious raceSurgical cliniciansSignificant health inequitiesLogistic regression analysisClinical treatment decisionsPatient care decisionsPatient management decisionsD scorePhysician-patient interactionDisadvantaged patientsPatient raceUnivariate analysisClinical assessmentCritical careTreatment decisionsMAIN OUTCOMELevel ISocial class biasWeb-based surveyClinician's roleHealth inequitiesCliniciansEmergency medicineUnconscious Race and Class Biases among Registered Nurses: Vignette-Based Study Using Implicit Association Testing
Haider AH, Schneider EB, Sriram N, Scott VK, Swoboda SM, Zogg CK, Dhiman N, Haut ER, Efron DT, Pronovost PJ, Freischlag JA, Lipsett PA, Cornwell EE, MacKenzie EJ, Cooper LA. Unconscious Race and Class Biases among Registered Nurses: Vignette-Based Study Using Implicit Association Testing. Journal Of The American College Of Surgeons 2015, 220: 1077-1086.e3. PMID: 25998083, DOI: 10.1016/j.jamcollsurg.2015.01.065.Peer-Reviewed Original Research
2014
Unconscious race and class bias
Haider A, Schneider E, Sriram N, Dossick D, Scott V, Swoboda S, Losonczy L, Haut E, Efron D, Pronovost P, Freischlag J, Lipsett P, Cornwell E, MacKenzie E, Cooper L. Unconscious race and class bias. Journal Of Trauma And Acute Care Surgery 2014, 77: 409-416. PMID: 25159243, DOI: 10.1097/ta.0000000000000392.Peer-Reviewed Original ResearchConceptsAcute care surgeonsSurgery of TraumaClinical decisionTrauma/acute care surgeonsEastern AssociationImplicit Association TestUnconscious raceProspective web-based surveyPhysicians' clinical decisionsLogistic regression analysisSurgeons' clinical decisionClinical vignettesImplicit biasesIAT scoresUnconscious preferenceMultivariable analysisPatient raceRace Implicit Association TestUnivariate analysisClinical assessmentPatient managementEpidemiologic studiesWeb-based surveyLevel IIWhite personsAssociation Between Race and Age in Survival After Trauma
Hicks C, Hashmi Z, Velopulos C, Efron D, Schneider E, Haut E, Cornwell E, Haider A. Association Between Race and Age in Survival After Trauma. JAMA Surgery 2014, 149: 642-647. PMID: 24871941, PMCID: PMC5995325, DOI: 10.1001/jamasurg.2014.166.Peer-Reviewed Original ResearchConceptsCharlson Comorbidity IndexPatients 65 yearsOlder patientsBlack patientsInjury severityComorbidity indexRacial disparitiesWhite patientsOdds ratioBetter outcomesCharlson Comorbidity Index scoreClinical Modification diagnosis codesLogistic regressionComorbidity Index scoreOlder black patientsOlder white patientsYoung black patientsYoung white patientsMost older patientsIntent of injuryNationwide Inpatient SampleMultivariable logistic regressionUnadjusted odds ratioUnivariable logistic regressionHead injury severityRace-based differences in length of stay among patients undergoing pancreatoduodenectomy
Schneider EB, Calkins KL, Weiss MJ, Herman JM, Wolfgang CL, Makary MA, Ahuja N, Haider AH, Pawlik TM. Race-based differences in length of stay among patients undergoing pancreatoduodenectomy. Surgery 2014, 156: 528-537. PMID: 24973128, DOI: 10.1016/j.surg.2014.04.004.Peer-Reviewed Original ResearchMeSH KeywordsAgedBlack or African AmericanCross-Sectional StudiesFemaleGeneral SurgeryHealthcare DisparitiesHispanic or LatinoHospital MortalityHospitalsHumansLength of StayLogistic ModelsMaleMiddle AgedPancreaticoduodenectomyPostoperative ComplicationsRacial GroupsRetrospective StudiesUnited StatesWhite PeopleConceptsHigh-volume hospitalsHigh-volume surgeonsHispanic patientsRace-based differencesWhite patientsMedian annual surgeon volumeAnnual hospital volumeAnnual surgeon volumeOverall median LOSNationwide Inpatient SampleMultivariable logistic regressionLength of stayHospital mortalityHospital lengthMedian LOSHospital volumeOperative morbidityProvider volumeSurgeon volumeMedian lengthPD patientsInpatient SamplePatient racePancreatoduodenectomyEligible individualsWorse outcomes among uninsured general surgery patients: Does the need for an emergency operation explain these disparities?
Schwartz D, Hui X, Schneider E, Ali M, Canner J, Leeper W, Efron D, Haut E, Velopulos C, Pawlik T, Haider A. Worse outcomes among uninsured general surgery patients: Does the need for an emergency operation explain these disparities? Surgery 2014, 156: 345-351. PMID: 24953267, DOI: 10.1016/j.surg.2014.04.039.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultCross-Sectional StudiesEmergency TreatmentFemaleHealthcare DisparitiesHumansMaleMedicaidMedically UninsuredMedicareMiddle AgedOdds RatioPatient Protection and Affordable Care ActPostoperative ComplicationsRetrospective StudiesSurgical Procedures, OperativeTreatment OutcomeUnited StatesYoung AdultConceptsEmergent operative managementEmergent operationWorse outcomesOperative managementNationwide Inpatient Sample 2005Retrospective cross-sectional analysisGeneral surgery patientsUrgency of operationGreater odds ratioHealth care accessCross-sectional analysisCovariates of ageColorectal operationsPayor statusPostoperative complicationsComplication rateSurgery patientsYounger patientsHispanic patientsMore complicationsInsurance statusOdds ratioUninsured groupCare accessPatientsThe Severity of Disparity: Increasing Injury Intensity Accentuates Disparate Outcomes Following Trauma
Losonczy L, Weygandt P, Villegas C, Hall E, Schneider E, Cooper L, Cornwell E, Haut E, Efron D, Haider A. The Severity of Disparity: Increasing Injury Intensity Accentuates Disparate Outcomes Following Trauma. Journal Of Health Care For The Poor And Underserved 2014, 25: 308-320. PMID: 24509028, PMCID: PMC6017993, DOI: 10.1353/hpu.2014.0021.Peer-Reviewed Original ResearchConceptsOdds of deathInjury severityGlasgow Coma Scale motor componentPatients meeting inclusion criteriaNational Trauma Data BankInjury Severity ScoreMechanism of injuryTrauma Data BankMeeting inclusion criteriaInsurance groupsRace/ethnicityHypotensive patientsTrauma mortalityBlack patientsHispanic patientsSeverity scoreUninsured patientsInclusion criteriaPatientsSevere injuriesLogistic regressionInjury intensityInjuryInsurance coverageSeverity
2013
Race and Insurance Disparities in Discharge to Rehabilitation for Patients with Traumatic Brain Injury
Asemota A, George B, Cumpsty-Fowler C, Haider A, Schneider E. Race and Insurance Disparities in Discharge to Rehabilitation for Patients with Traumatic Brain Injury. Journal Of Neurotrauma 2013, 30: 2057-2065. PMID: 23972035, PMCID: PMC3868359, DOI: 10.1089/neu.2013.3091.Peer-Reviewed Original ResearchConceptsTraumatic brain injuryBrain injurySevere traumatic brain injuryAdult TBI survivorsInsurance-based differencesOdds of dischargeHospital-level variablesImproved functional outcomesMeeting study criteriaMultivariable logistic regressionNationwide Inpatient SampleInpatient rehabilitation servicesInsurance-based disparitiesStandard descriptive methodsUninsured blacksUninsured HispanicsInpatient rehabilitationFunctional outcomeStudy criteriaInpatient SampleInsurance statusInpatient careTBI survivorsRehabilitation servicesLogistic regressionMinority Trauma Patients Tend to Cluster at Trauma Centers with Worse-Than-Expected Mortality
Haider A, Hashmi Z, Zafar S, Hui X, Schneider E, Efron D, Haut E, Cooper L, MacKenzie E, Cornwell E. Minority Trauma Patients Tend to Cluster at Trauma Centers with Worse-Than-Expected Mortality. Annals Of Surgery 2013, 258: 572-581. PMID: 23979271, PMCID: PMC5995334, DOI: 10.1097/sla.0b013e3182a50148.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedAged, 80 and overBlack or African AmericanDatabases, FactualFemaleHealth Status DisparitiesHealthcare DisparitiesHispanic or LatinoHospital MortalityHumansInjury Severity ScoreLogistic ModelsMaleMiddle AgedMinority HealthMultivariate AnalysisOutcome Assessment, Health CareTrauma CentersUnited StatesWhite PeopleWounds, NonpenetratingWounds, PenetratingYoung AdultConceptsTrauma centerNational Trauma Data Bank 2007High mortalityLevel I/II trauma centersPatient/injury characteristicsE mortality ratioPatients 16 yearsInjury Severity ScoreMultivariate logistic regressionIndividual trauma centersNumber of deathsBlunt/Trauma patientsBlack patientsInjury characteristicsSeverity scoreMortality ratioTraumatic injuryLower mortalityLogistic regressionPatientsRacial disparitiesMortalityInjurySurvivalNational disparities in laparoscopic colorectal procedures for colon cancer
AlNasser M, Schneider E, Gearhart S, Wick E, Fang S, Haider A, Efron J. National disparities in laparoscopic colorectal procedures for colon cancer. Surgical Endoscopy 2013, 28: 49-57. PMID: 24002916, DOI: 10.1007/s00464-013-3160-8.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overAsianBlack or African AmericanColonic NeoplasmsCross-Sectional StudiesFemaleHealthcare DisparitiesHispanic or LatinoHospitals, TeachingHospitals, UrbanHumansInsurance CoverageLaparoscopyLogistic ModelsMaleMiddle AgedMultivariate AnalysisNeoplasm StagingRacismSocioeconomic FactorsUnited StatesWhite PeopleConceptsLaparoscopic colorectal proceduresLaparoscopic proceduresColorectal cancerColorectal proceduresInsurance statusLaparoscopic surgeryNationwide Inpatient Sample databaseDiagnosis of CRCNinth Revision codesRate of laparoscopyAfrican American patientsMultivariate logistic regressionCRC surgeryCRC patientsResultsA totalRevision codesInsurance typeOpen procedureTeaching hospitalHospital typeHigher oddsUrban hospitalInternational ClassificationHealthcare costsColon cancerCounting the lives lost: how many black trauma deaths are attributable to disparities?
Scott V, Hashmi Z, Schneider E, Hui X, Efron D, Cornwell E, Cooper L, Haider A. Counting the lives lost: how many black trauma deaths are attributable to disparities? Journal Of Surgical Research 2013, 184: 480-487. PMID: 23827793, PMCID: PMC5995316, DOI: 10.1016/j.jss.2013.04.080.Peer-Reviewed Original ResearchConceptsBlack patientsRisk of mortalityTrauma deathsRelative riskLevel IWhite patientsNational Trauma Data BankLevel II trauma centerRacial disparitiesTrauma center deathsTrauma Data BankWhite malesNumber of deathsTrauma centerExcess mortalityTrauma outcomesRetrospective analysisOutcome disparitiesPatientsExcess deathsMortalityDeathRiskInjuryBlunt