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Racial and socioeconomic disparities in cost and postoperative complications following sacrocolpopexy in a US National Inpatient Database

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Abstract

Purpose

We sought to determine the association between socioeconomic factors, procedural costs, and postoperative complications among patients who underwent sacrocolpopexy.

Methods

The 2016–2017 US National Inpatient Sample from the Healthcare Cost and Utilization Project was used to identify females > 18 years of age with an ICD10 diagnosis code of apical prolapse who received open or laparoscopic/robotic sacrocolpopexy. We analyzed relationships between socioeconomic factors, procedural costs, and postoperative complications in these patients. Multivariate logistic and linear regressions were used to identify variables associated with increased complications and costs, respectively.

Results

We identified 4439 women who underwent sacrocolpopexy, of which 10.7% had complications. 34.6% of whites, 29.1% of Blacks, 29% of Hispanics, and 34% of Others underwent a laparoscopic/robotic procedure. Hispanic patients had the highest median charge associated with surgical admission for sacrocolpopexy at $51,768, followed by Other ($44,522), White ($43,471), and Black ($40,634) patients. Procedure being within an urban teaching hospital (+ $2602), laparoscopic/robotic (+ $6790), or in the West (+ $9729) were associated with a significantly higher median cost of surgical management.

Conclusions

In women undergoing sacrocolpopexy, the protective factors against postoperative complications included private insurance status, a laparoscopic approach, and concurrent hysterectomy. Procedures held within an urban teaching hospital, conducted laparoscopically/robotically or in the West are associated with significantly higher costs of surgical management. Hispanic patients observe significantly higher procedure charges and costs, possibly resulting from the large number of this ethnic group living in the Western United States.

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Authors and Affiliations

  1. University of Miami Miller School of Medicine, Miami, FL, USA

    Aaron A. Gurayah, Matthew M. Mason, Meghan R. Grewal & Sirpi Nackeeran

  2. Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL, USA

    Laura E. Martin, Katherine Amin & Raveen Syan

  3. Division of Urogynecology and Pelvic Floor Disorders, Women’s Health Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Shannon L. Wallace

Authors
  1. Aaron A. Gurayah
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  2. Matthew M. Mason
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  3. Meghan R. Grewal
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Correspondence to Raveen Syan.

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Gurayah, A.A., Mason, M.M., Grewal, M.R. et al. Racial and socioeconomic disparities in cost and postoperative complications following sacrocolpopexy in a US National Inpatient Database. World J Urol 41, 189–196 (2023). https://doi.org/10.1007/s00345-022-04226-6

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  • DOI: https://doi.org/10.1007/s00345-022-04226-6

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