Increased Cost Of Unplanned Hospitalizations For Racial Minorities After Common Plastic Surgery Procedures
Jacob Nasser, BS, Jessica Billig, MD, MS, Chang Wang, BS, Lu Wang, PhD, Kevin C. Chung, MD, MS.
University of Michigan, Ann Arbor, MI, USA.
PURPOSE: The association of systems-level inequities with surgical outcomes resulting in racial disparities has been identified in the literature. Nonetheless, the effect for patients in the postoperative period is not well understood. We aimed to identify the effect of race on the rate and cost of unplanned hospitalizations after reconstructive plastic surgery.
METHODS: An analysis of the Healthcare Cost and Utilization Project (HCUP) from 2006 to 2015 was used to identify adult patients undergoing autologous and implant-based breast reconstruction and abdominoplasty. Multivariable analyses were performed to determine the association of race with readmission rate and costs.
RESULTS: Five percent of the 17,739 patients included in our sample experienced a readmission. There was no significant difference in the readmission rate for Black and Hispanic patients compared to White patients (Black patients OR:0.87, 95% CI:0.70-1.09, Hispanic patients OR:1.10, 95% CI:0.86-1.40). However, Black (OR:1.28, 95% CI:1.05-1.56) and Hispanic patients (OR:1.27, 95% CI:1.03-1.58) had increased odds of incurring greater cost compared to White patients, despite controlling for income and comorbidities (Figure 1).
CONCLUSION:
Racial minorities bear a substantially higher cost for readmission for breast and abdominoplasty procedures, resulting in discrepancies in access and care provision. Systems-level issues may influence access to care which can lead to delayed diagnoses. Future research is needed to examine the role of different payment models on inequities and identify solutions to foster more equitable care. 
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