Disparities in Anesthesia Care
1. What is the decision or change you are facing or struggling with where a summary of the evidence would be helpful?
What are potential methods of decreasing healthcare disparities in patients receiving anesthesia care? This includes access to surgical and diagnostic care and the quality of care received as it relates to morbidity and mortality of patients. The disparities may be based on, but not limited to, gender, race, socioeconomic status, language, and sexual orientation.
2. Why are you struggling with this issue?
There are many studies proving that healthcare disparities exist in the perioperative setting. However, we are unaware of studies showing how specific interventions decrease these disparities in anesthesia care. For instance, studies have shown a difference in anesthesia type based on race for laboring patients requiring operative as well as non-operative obstetrical care.1,2 Likewise, there has been demonstrated a difference in anesthesia care based on gender during inguinal hernia repair.3 Outcomes in the septic patient has been shown to vary based on race.4
References
1. Butwick AJ, Blumenfeld YJ, Brookfield KF, Nelson LM, Weiniger CF. Racial and Ethnic Disparities in Mode of Anesthesia for Cesarean Delivery. Anesth Analg. 2016 Feb;122(2):472-9. doi: 10.1213/ANE.0000000000000679. PMID: 26797554; PMCID: PMC4724639.
2. Glance LG, Wissler R, Glantz C, Osler TM, Mukamel DB, Dick AW. Racial differences in the use of epidural analgesia for labor. Anesthesiology. 2007 Jan;106(1):19-25; discussion 6-8. doi: 10.1097/00000542-200701000-00008. PMID: 17197841.
3. Memtsoudis SG, Besculides MC, Swamidoss CP. Do race, gender, and source of payment impact on anesthetic technique for inguinal hernia repair? J Clin Anesth. 2006 Aug;18(5):328-33. doi: 10.1016/j.jclinane.2005.08.006. PMID: 16905076.
4. Barnato AE, Alexander SL, Linde-Zwirble WT, Angus DC. Racial variation in the incidence, care, and outcomes of severe sepsis: analysis of population, patient, and hospital characteristics. Am J Respir Crit Care Med. 2008 Feb 1;177(3):279-84. doi: 10.1164/rccm.200703-480OC. Epub 2007 Nov 1. PMID: 17975201; PMCID: PMC2720103.
3. What do you want to see changed? How will you know that your issue is improving or has been addressed?
We would like to know what strategies anesthesiologists and other anesthesia professionals use or are being developed to decrease healthcare disparities among patients receiving anesthesia care. Currently, we have access to a clinical outcomes registry whereby anesthesiologists can report various outcomes but patient demographics, including race and gender, are not routinely captured. Based upon what intervention takes place, we believe groups could initially use an anesthesiology-focused patient satisfaction survey to help define improvement and, in the long term, use a more robust set of data elements and capture systems to track patient outcomes and disparities over time.
4. When do you need the evidence report?
Fri, 12/31/2021
5. What will you do with the evidence report?
We expect to incorporate this research into our measure development and maintenance processes for the American Society of Anesthesiologists. In addition, we would investigate providing a narrative with links to the research in our member publications. Finally, we can engage academic anesthesiologists to teach these interventions to resident physician anesthesiologists and to assure that practicing anesthesiologists implement best practices on identifying and reducing disparities in patients receiving anesthesia care. Translating these studies into patient-centered actions, we believe, will decrease disparities and improving patient experience with the healthcare team.
(Optional) About You
What is your role or perspective? Physician
If you are you making a suggestion on behalf of an organization, please state the name of the organization: The American Society of Anesthesiologists Committee on Performance and Outcomes Measurement
May we contact you if we have questions about your nomination? Yes
