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Black patients have higher rates of delayed appendicitis diagnosis and 30-day hospital use than White patients, according to a study published online Jan. 18 in JAMA Surgery.

Ana M. Reyes, M.D., from Northwestern University in Chicago, and colleagues assessed whether patient race and ethnicity are associated with delayed appendicitis diagnosis and postoperative 30-day hospital use. The analysis included data from inpatient and emergency department databases from four states (Florida, Maryland, New York, and Wisconsin) for 80,312 adults (aged 18 to 64 years) who underwent appendectomy from Jan. 7, 2016, to Dec. 1, 2017.

The researchers found that 2.5 percent of patients experienced delayed diagnosis, with non-Hispanic Black patients having a 1.41 times higher adjusted rate of delayed diagnosis versus non-Hispanic White patients. Patients at hospitals with a Black or Hispanic population >50 percent had a 0.73 decreased adjusted rate of delayed appendicitis diagnosis versus hospitals with a <25 percent Black or Hispanic population. However, patients at hospitals with >50 percent of discharges of Medicaid patients had a 3.51 higher adjusted rate of delayed diagnosis versus hospitals with <10 percent of discharges of Medicaid patients. Delayed diagnosis was also associated with female sex, higher levels of patient comorbidity, and living in a low-income ZIP code. There was an increased adjusted rate of postoperative 30-day hospital use (1.38) associated with delayed diagnosis.

“It may be hospitals that are more used to serving racial-ethnic minority patients are better at diagnosing them, because they’re more culturally informed and have a better understanding of these patients,” one author said in a statement.

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