ArticleDiseases of the colon and rectum2017
Racial and Socioeconomic Differences Manifest in Process Measure Adherence for Enhanced Recovery After Surgery Pathway.
Article in Diseases of the colon and rectum, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of social determinants of health on access to partial nephrectomy, minimally invasive surgery, and robotic-assisted approaches for renal cell carcinoma.World journal of urology · 2026Pooled it
- Quality indicators for structure and process in peri-operative care: a systematic review.Anaesthesia · 2026Pooled it
- The Impact of Social Determinants of Health on Severe Colorectal Complications.Clinics in colon and rectal surgery · 2026Review
- Predictors of Patient-Reported Receipt of Preoperative Education in an Enhanced Recovery Program.The Journal of surgical research · 2025Article
- Inequities in 'failure to rescue' for Indigenous Māori after gastrointestinal cancer surgery in New Zealand.The British journal of surgery · 2025Article
- A realist review of how, why, for whom and in which contexts quality improvement in healthcare impacts inequalities.BMJ quality & safety · 2025Review
- Complications and length of stay after enhanced recovery after surgery compared to conventional care in colorectal cancer patients in Northern Italy.Frontiers in surgery · 2025Article
- Preoperative Education is Associated with Adherence to Downstream Components and Outcomes in a Colorectal Surgery Enhanced Recovery Program.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Adapting Enhanced Recovery After Surgery (ERAS) Protocols to Promote Equity in Cancer Care and Outcomes.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- The association of social vulnerability with colorectal enhanced recovery program failure.Surgery open science · 2023Article
- A comparison of patient-reported outcomes among Canadian women having hysterectomies.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023Article
- Article
- Patient Characteristics Influencing Adherence to Enhanced Recovery Protocols for Colorectal Surgery: a Multicentric Prospective Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Race, ethnicity, and the use of regional anesthesia in cancer patients undergoing open abdominal surgery: A single-center retrospective cohort study.Frontiers in medicine · 2022Article
- Psychosocial Risks are Independently Associated with Cancer Surgery Outcomes in Medically Comorbid Patients.Annals of surgical oncology · 2019Observational
- Enhancing the study of enhanced recovery after thoracic surgery: methodology and population-based approaches for the future.Journal of thoracic disease · 2019Review
- Racial Disparities in Outcomes of Bariatric Surgery: An Analysis of 190,319 Patients.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
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Authors and funding
7 authors.
Funding
Abstract
backgroundAdherence to care processes and surgical outcomes varies by population subgroups for the same procedure. Enhanced recovery after surgery pathways are intended to standardize care, but their effect on process adherence and outcomes for population subgroups is unknown.
objectiveThis study aims to demonstrate the association between recovery pathway implementation, process measures, and short-term surgical outcomes by population subgroup.
designThis study is a pre- and post-quality improvement implementation cohort study.
settingThis study was conducted at a tertiary academic medical center.
interventionA modified colorectal enhanced recovery after surgery pathway was implemented. PATIENTS: Patients were included who had elective colon and rectal resections before (2013) and following (2014-2016) recovery pathway implementation.
main outcome measureThirty-day outcomes by race and socioeconomic status were analyzed using a difference-in-difference approach with correlation to process adherence.
resultsWe identified 639 cases (199 preimplementation, 440 postimplementation). In these cases, 75.2% of the patients were white, and 91.7% had a high socioeconomic status. Groups were similar in terms of other preoperative characteristics. Following pathway implementation, median lengths of stay improved in all subgroups (-1.0 days overall, p ≤ 0.001), but with no statistical difference by race or socioeconomic status (p = 0.89 and p = 0.29). Complication rates in both racial and socioeconomic groups were no different (26.4% vs 28.8%, p = 0.73; 27.3% vs 25.0%, p = 0.86) and remained unchanged with implementation (p = 0.93, p = 0.84). By race, overall adherence was 31.7% in white patients and 26.5% in nonwhite patients (p = 0.32). Although stratification by socioeconomic status demonstrated decreased overall adherence in the low-status group (31.8% vs 17.1%, p = 0.05), white patients were more likely to have regional pain therapy (57.1% vs 44.1%, p = 0.02) with a similar trend seen with socioeconomic status. LIMITATIONS: Data were collected primarily for quality improvement purposes.
conclusionsDifferences in outcomes by race and socioeconomic status did not arise following implementation of an enhanced recovery pathway. Differences in process measures by population subgroups highlight differences in care that require further investigation. See Video Abstract at http://links.lww.com/DCR/A386.
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