Evidence map›Paper›PMID 37679584›Full record

ArticleSurgical endoscopy2023

Disparities in access to minimally invasive surgery for inflammatory bowel disease and outcomes by insurance status: analysis of the 2015 to 2019 National Inpatient Sample.

Yung Lee, Lauren Andrew, Sarah Hill, Kevin R An, Louisa Chatroux, Sama Anvari, Dennis Hong, Angela H Kuhnen

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
5.1field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Prevalence and Impact of Social Risk in Patients With Inflammatory Bowel Diseases: National Estimates From the United States.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2025
    Article
  6. Review
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

Yung LeeDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Lauren AndrewDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Sarah HillDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Kevin R AnDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Louisa ChatrouxDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Sama AnvariDivision of Gastroenterology, McMaster University, Hamilton, ON, Canada.
Dennis HongDivision of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Angela H KuhnenDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA. angela.h.kuhnen@lahey.org.ORCID 0000-0003-4944-9143
Harvard University · USMcMaster University · CABrigham and Women's Hospital · USLahey Hospital and Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionDespite being the preferred modality for treatment of colorectal cancer and diverticular disease, minimally invasive surgery (MIS) has been adopted slowly for treatment of inflammatory bowel disease (IBD) due to its technical challenges. The present study aims to assess the disparities in use of MIS for patients with IBD.

methodsA retrospective analysis of the National Inpatient Sample (NIS) database from October 2015 to December 2019 was conducted. Patients < 65 years of age were stratified by either private insurance or Medicaid. The primary outcome was access to MIS and secondary outcomes were in-hospital mortality, complications, length of stay (LOS), and total admission cost. Univariate and multivariate regression was utilized to determine the association between insurance status and outcomes.

resultsThe NIS sample population included 7866 patients with private insurance and 1689 with Medicaid. Medicaid patients had lower odds of receiving MIS than private insurance patients (OR 0.85, 95% CI [0.74-0.97], p = 0.017), and experienced more postoperative genitourinary complications (OR 1.36, 95% CI [1.08-1.71], p = 0.009). In addition, LOS was longer by 1.76 days (p < 0.001) and the total cost was higher by $5043 USD (p < 0.001) in the Medicaid group. Independent predictors of receiving MIS were age < 40 years old, female sex, highest income quartile, diagnosis of ulcerative colitis, elective admission, and care at teaching hospitals.

conclusionsPatients with Medicaid are less likely to receive MIS, have longer lengths of stay, and incur higher costs for the surgical management of their IBD. Further investigations into disparities in inflammatory bowel disease care for Medicaid patients are warranted.

Indexed as

Inflammatory Bowel DiseasesInpatientsAdultFemaleHumansInsurance CoverageMinimally Invasive Surgical ProceduresRetrospective StudiesUnited StatesCrohn’s diseaseIBDInflammatory bowel diseaseMinimally invasive surgeryNISUlcerative colitis

Identifiers

PMID37679584
OpenAlexW4386499137

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.