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Comment on: Black-versus-White racial disparities in 30-day outcomes at MBSAQIP-accredited centers: a needed quality indicator

Published:January 18, 2023DOI:https://doi.org/10.1016/j.soard.2023.01.007
      Although it is well recognized that metabolic surgery is the most effective treatment for obesity and related comorbid conditions, outcomes do vary and disparities do exist. Using the data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) registry, Yang et al., found higher rates of morbidity, readmissions, reoperations and postoperative interventions among Black patients when compared to White patients.(

      Yang AZ, Jung JJ, Hutter, MM, Black-versus-White racial disparities in 30-day outcomes at MBSAQIP-accredited centers: a needed quality indicator, SOARD, 2023.

      ) Their findings mirror those reported at the state level, which indicates that variation in outcomes between Black and White patients is both a local and national phenomenon in the United States.(

      Wood MH, Carlin AM, Ghaferi AA, et al. Association of Race With Bariatric Surgery Outcomes. JAMA Surg.2019;154(5):e190029. doi:10.1001/jamasurg.2019.0029

      ) Given the need to improve the delivery of equitable care, the authors propose creating a Disparities Metric that can be included in site-specific semi-annual reports. They are to be commended for offering a data-driven way to bridge the gap in disparities, however, given the complexity of the problem, the pervasive nature of obesity and the heterogeneity that can be found within different communities across the United States, numerous limitations exist, as noted by the authors. Nevertheless, improving equity in healthcare remains an important quality metric and using data to identify variation in outcomes between certain patient populations can help develop solutions as well as measure success.
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      References:

      1. Yang AZ, Jung JJ, Hutter, MM, Black-versus-White racial disparities in 30-day outcomes at MBSAQIP-accredited centers: a needed quality indicator, SOARD, 2023.

      2. Wood MH, Carlin AM, Ghaferi AA, et al. Association of Race With Bariatric Surgery Outcomes. JAMA Surg.2019;154(5):e190029. doi:10.1001/jamasurg.2019.0029

      3. Wang M, Pantell MS, Gottlieb LM, Adler-Milstein J. Documentation and review of social determinants of health data in the EHR: measures and associated insights. J Am Med Inform Assoc. 2021 Nov 25;28(12):2608-2616. doi: 10.1093/jamia/ocab194. PMID: 34549294; PMCID: PMC8633631.

      4. Byhoff E, Cohen AJ, Hamati MC, Tatko J, Davis MM, Tipirneni R. Screening for Social Determinants of Health in Michigan Health Centers. J Am Board Fam Med. 2017 Jul-Aug;30(4):418-427. doi: 10.3122/jabfm.2017.04.170079. PMID: 28720624.

      5. Stanford FC, Lee M, Hur C. Race, Ethnicity, Sex, and Obesity: Is It Time to Personalize the Scale? Mayo Clin Proc. 2019 Feb;94(2):362-363. doi: 10.1016/j.mayocp.2018.10.014. PMID: 30711132; PMCID: PMC6818706.

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