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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