Racial Disparities Mitigated for Universally Insured Military Patients

Racial Disparities Mitigated for Universally Insured Military Patients
Center for Surgery and Public Health

Racial disparities within the U.S. healthcare system are estimated to account for more than 83,000 deaths and an average of more than $57 billion per year, and are often attributed to the lack of insurance or access to care among minority populations. Even with the passage of the Affordable Care Act and an increase in insurance coverage and access to care, disparities in outcomes persist in minority populations. A longitudinal analysis by the CSPH’s Military Outcomes Research program published in the Journal of Trauma and Acute Care Surgery was the first of its kind to find that racial disparities are mitigated among a population of universally insured military patients.

Researchers from this program analyzed five years (2006-2010) of TRICARE data. Emergency General Surgery (EGS) conditions (which include a wide spectrum of procedures for the upper and lower gastrointestinal tract, hepatobiliary and pancreatic disease, soft tissue infections, and hernias) were primarily chosen because their emergent nature is thought to lessen subjective external factors.

Researchers looked at mortality, major morbidity, and readmission rates for 101,011 EGS patients representing four racial groups (white, black, Asian, or other), a population which is broadly representative of the insured American public. They found no differences in mortality and readmission rates at 30, 90 or 180 days for patients across racial groups, and only minimal differences in major morbidity between black and white patients. These findings are a stark departure from the gaping disparities which have been demonstrated among those in the general (civilian) population, and demonstrate the team’s commitment to the adage that “in the MHS, the color of the uniform is more important than the color of the skin.”

Schoenfeld AJ, Jiang W, Harris MB, Cooper Z, Koehlmoos T, Learn PA, Weissman JS, and Haider AH, 2017. Association between race and postoperative outcomes in a universally insured population versus patients in the State of California. Annals of surgery, 266(2), pp.267-273.