Racial and Socioeconomic Disparities in Reduction Mammoplasty An Analysis of Nationwide Inpatient Sample Database
Division of Plastic Surgery, Department of Surgery, Western Campus-Tufts University School of Medicine, Baystate Medical Center, Springfield, MA, USA.Annals of plastic surgery (Impact Factor: 1.49). 03/2011; 66(5):476-8. DOI: 10.1097/SAP.0b013e3182185efa
The American Society of Plastic Surgery recently recorded a decline in numbers of breast reductions, one of the most common procedures performed by plastic surgeons. The purpose of this study is to characterize the reduction mammoplasty patient population which would further assist in planning the future workforce needs. Using the Nationwide Inpatient Sample database for 2007, a χ analysis of female in-patients treated with reduction mammoplasty for breast hypertrophy was performed to identify significant differences in race and payer mix. Of 8394 female in-patients with breast hypertrophy, 61% were treated with reduction mammoplasty. Black and Hispanic patients (P < 0.0001) and patients with private insurance (P < 0.0001) were more likely to undergo reduction mammoplasty. This study demonstrates racial and socioeconomic disparities in breast reduction in the United States in 2007. With the pending institution of universal healthcare, it is predicted that disparities revealed may worsen due to cost containment pressures.
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ABSTRACT: Large breast is a major problem because of associated symptomatology and aesthetic concerns. Reduction mammoplasty (RM) resolves the symptom and at the same time improves the aesthetic appearance of the breast, hence improving self-esteem and social integration. To describe the pattern of RM in a hospital in the developing world and its impact on postgraduate surgical training. A retrospective review of all the RMs done in the National Orthopaedic Hospital, Enugu (a major plastic surgery training center in Nigeria) over a ten-year period (2001-2010), in the developing country of Nigeria. All RMs done in the hospital were reviewed after retrieving their records from operation register and medical records department. Fifteen (15) cases were retrieved and analyzed. Data was analyzed with Microsoft excel 2007. Average age of female patients who had RM was 26.5 years and 83.3% were single. The most common complaint was abnormally large breast (macromastia). Inferior pedicle technique was commonly used. The results of RM are remarkable as it impact positively on the quality of life of the patients. However, the level of awareness about the availability of this service is still low in the region as shown by few cases done over the period of review and this impacts negatively on the training. The need for public awareness cannot be overemphasized.
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ABSTRACT: Pediatric breast reduction mammaplasty is a procedure commonly performed in children suffering from excess breast tissue, back pain, and social anxiety. Minimal information exists regarding demographics, epidemiology, and complications in adolescents. As health care reform progresses, investigating the socioeconomic and patient-related factors affecting cost and operative outcomes is essential. The Kids' Inpatient Database (KID) was used from 2000 to 2009. Patients with an International Classification of Diseases, 9th Revision code of macromastia and procedure code of reduction mammaplasty 20 and less were included. Demographic data, including age, sex, payer mix, and location, were collected. Significant independent variables associated with complications and duration of stay were identified with bivariate and multiple regression analysis. A total of 1,345 patients between the ages 12 and 20 were evaluated. The majority of patients were white (64%), from a zip code with greatest income (36%), and had private insurance (75%). Overall comorbidity and complication rates were 30% and 3.2%, respectively. Duration of stay was associated with race, income quartile, insurance type, having complications, and hospital type. African-American race, Medicaid, lower income, and private-investor owned hospitals were predictive of greater hospital charges. In this large retrospective database analysis, pediatric reduction mammaplasty had a relatively low early complication rate and short duration of stay. Complications, total charges, and duration of stay discrepancies were associated with race, location, and socioeconomic status. Although demonstrably safe, this is the first study demonstrating the negative effect of race and socioeconomic status on a completely elective procedure involving children. These results demonstrate the intricate association between socioeconomic and patient-related factors influencing overall outcomes in the pediatric population. Copyright © 2015 Elsevier Inc. All rights reserved.
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