4.4 Article

Racial and geographic disparities in reconstructive procedures following melanoma resection

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ELSEVIER SCI LTD
DOI: 10.1016/j.bjps.2022.08.031

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Hospitalization; Insurance; Income; Demography

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Race and socioeconomic factors are important predictors for access to complex reconstructive procedures and hospital-based outcomes in melanoma patients.
Introduction: Melanoma occurs most commonly in non-Hispanic White patients; however, Black and Hispanic patients experience greater morbidity and mortality. This study assesses how race and socioeconomic factors influence rates of reconstructive procedures and hospital-based outcomes in melanoma patients.Methods: Data were extracted from the National Inpatient Sample database from the years 2010-2015. Patients with melanoma who underwent a reconstructive procedure were iden-tified. Univariate and multivariate logistic regression analysis was used to identify the rela-tionship between dependent variables and various patient/hospital components for patients undergoing reconstructive procedures.Results: Black and Hispanic patients had a greater length of stay (LOS) than non-Hispanic White patients (OR: 2.252, p = 0.0307, and OR: 2.592, p = 0.0014), and Hispanic patients were less likely to receive more complex reconstructive procedures (OR: 0.449, p = 0.0487). Patients living in rural areas were less likely to receive complex reconstructive procedures than those in both urban teaching and non-teaching hospitals (OR: 3.313, p = 0.0135, and OR: 3.505, p = 0.0074). Pedicled or rotational flaps were less likely to be performed at medium-or large -sized hospitals (OR: 0.610, p = 0.0296, and OR: 0.496, p = 0.0002).Conclusion: Race and socioeconomic factors are important predictors of access to complex reconstructive procedures and hospital-based outcomes following extirpation in melanoma pa-tients.(c) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by El-sevier Ltd. All rights reserved.

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