Racial disparities in hospitalization outcomes among patients with cholangiocarcinoma.

Inimfon Jackson Albert Einstein Medical Center, Philadelphia, PA info_outline Inimfon Jackson, Gogo-Ogute Ibodeng, Geneva Guarin, Claudia M. Dourado

Authors Inimfon Jackson Albert Einstein Medical Center, Philadelphia, PA info_outline Inimfon Jackson, Gogo-Ogute Ibodeng, Geneva Guarin, Claudia M. Dourado Organizations Albert Einstein Medical Center, Philadelphia, PA, Thomas Hospital- Infirmary Health, Fairhope, AL Abstract Disclosures Research Funding No funding received None. Background: Studies have reported on the rising incidence and mortality outcomes among patients diagnosed with cholangiocarcinoma (CCA) but racial disparities in outcomes among inpatients have not been explored in this population. We examined the racial disparities in outcomes among adult hospitalized patients with a diagnosis of CCA. Methods: Retrospective cohort analyses were conducted using data from the National Inpatient Sample (NIS), 2016-2020. Multivariate logistic and linear regression models were used to examine the association between race/ethnicity and patient disposition, length of stay, elective admissions, and total hospital charges. Results: In the adjusted analyses, while Black patients had 14% higher odds (95% Confidence Interval (CI): 1.04–1.25) of being discharged to a facility/home with home health care versus routine discharge when compared to their White counterparts, Hispanics had 14% lower odds (95% CI: 0.79–0.95). Black patients had 39% higher risk (95% CI: 1.19–1.63) of death versus routine discharge relative to the White patients. Compared to White patients, Blacks (AOR: 1.23; 95% CI: 1.13–1.34), Hispanics (AOR: 1.15; 1.06–1.25) and other race/ethnicities (AOR: 1.20; 1.10–1.31) were more likely to have a length of hospital stay greater than 5 days relative to 5 days or less. Hispanics (β: $16,789; 95% CI: $11,480–$22,099) were found to have higher total hospital charges when compared to the White CCA patients. Additionally, Black (AOR: 0.68; 95% CI: 0.60–0.78) and Hispanic patients (AOR: 0.87; 95% CI: 0.77–0.99) were less likely to be admitted electively to the hospital. Conclusions: Despite advances made in treatment of patients with CCA, the prognosis remains poor. We report disparities in various hospitalization outcomes among adult patients with a diagnosis of CCA. Health care providers need to be aware that these disparities exist and health policies should be implemented to narrow the gap in existing disparities. Racial disparities in hospitalization outcomes among patients with cholangiocarcinoma using the NIS (2016–2020). Race/Ethnicity Whites Blacks Hispanics Others Facility/Home Health Vs Routine [AOR (95% CI)] Ref 1.14 (1.04–1.25) 0.86 (0.79–0.95) 0.89 (0.80–0.99) Died Vs Routine [AOR (95% CI)] Ref 1.39 (1.19–1.63) 0.89 (0.75–1.05) 1.06 (0.90–1.26) Elective admission [AOR (95% CI)] Ref 0.68 (0.60–0.78) 0.87 (0.77–0.99) 0.88 (0.78–1.00) Length of stay >5 days [AOR (95% CI)] Ref 1.23 (1.13–1.34) 1.15 (1.06–1.25) 1.20 (1.10–1.31) Total charges [β (95% CI)] Ref 3914.47 (-35.82–7864.75) 16789.48 (11480.02–22098.95) 14293.19 (9138.74–19447.64) NIS – National Inpatient Sample; AOR= Adjusted odds ratio; β=point estimate; Ref=Reference; CI=confidence intervals; models adjusted for age, gender, hospital region, hospital location, Charlson comorbidity index and type of insurance, boldface signifies statistical significance.