Racial Differences in Hysterectomy Route Selection Public

Abstract

This study explored racial differences in the selection of hysterectomy route between abdominal hysterectomy and two minimally invasive nonabdominal approaches, vaginal and laparoscopic hysterectomy. A logistic regression examined the existence of racial difference and a linear probability fixed effect model explored if these racial differences persisted after controlling for unobservable differences between hospitals. A weighted sample of 570,627 patients who had received a hysterectomy for benign disease was analyzed from the 2009-2010 Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP). We found that minority women had an increased likelihood of receiving an abdominal hysterectomy over White women, particularly Black and Asian or Pacific Islander women at an increase of 18% and 16%, respectively. Though the magnitude of the probability decreased after within hospital analysis, all minority women had an increased likelihood of abdominal hysterectomy receipt when compared to white women.

Table of Contents

Abstract 3 Introduction 4 Study Significance 4 Research Questions 5 Conceptual Framework 6 Literature Review 7 Background 7 Summary of the Literature 10 Methods 11 Data 11 Sample 12 Design 13 Dependent Variables 13 Key Independent Variable 13 Covariates 14 Research Questions 17 Statistical Analysis 18 Results 19 Descriptive Statistics 19 Research Question 1 27 Research Question 2 29 Summary of Findings 30 Research Question 1 30 Research Question 2 30 Discussion 31 Limitations 32 Policy Implications 33 Future Research 35 Looking Forward 36 Patient Education 36 Value-based Reimbursements 37 Conclusion 37 References 39 Appendix 44

About this Master's Thesis

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School	Rollins School of Public Health
Department	Health Policy and Management
Degree	MSPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Obstetrics and Gynecology
Mot-clé	gynecology racial disparity racial differences hysterectomy women's health
Committee Chair / Thesis Advisor	Gaydos, Laura, Emory University Joski, Peter J, Emory University
Committee Members	Blake, Sarah, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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