Examining healthcare inequities relative to United States safety net hospitals.
INTRODUCTION
The impact of safety net (SN) hospitals relative to racial and healthcare disparities remains largely unknown.


METHODS
Using the Nationwide Inpatient Sample, adults undergoing coronary artery bypass grafting, colectomy, or total hip arthroplasty were identified. Multivariable regression analysis was performed to determine association between SN burden and outcomes. Within each SN burden tier, the association between race/ethnic group and outcomes was defined.


RESULTS
Overall 865,648 patients were identified. After adjustment for potential confounders, patients operated at the highest SN burden hospitals had increased odds of complications (OR 1.14, 95%CI 1.10-1.18), death (OR 1.41, 95%CI 1.31-1.52), FTR (OR 1.36, 95%CI 1.25-1.47) and a never event (OR 1.57, 95%CI 1.47-1.68). Irrespective of hospital SN burden, racial minorities had greater odds of a complication, and prolonged LOS compared to whites (p < 0.05).


CONCLUSION
While overall degree of safety net burden was associated with worse overall outcomes, SN hospitals did not mitigate racial disparities experienced by minority patients.
['Paredes|Anghela Z|AZ|', 'Hyer|J Madison|JM|', 'Diaz|Adrian|A|', 'Tsilimigras|Diamantis I|DI|', 'Pawlik|Timothy M|TM|']
D000328:Adult D000368:Aged D019644:Arthroplasty, Replacement, Hip D003082:Colectomy D001026:Coronary Artery Bypass D005006:Ethnicity D005260:Female D054625:Healthcare Disparities D006801:Humans D008297:Male D008875:Middle Aged D011183:Postoperative Complications D064876:Safety-net Providers D014481:United States
Inequity Disparities Safety net burden