Racial disparities in health outcomes have been demonstrated across many surgical disciplines including colorectal surgery. With post-operative lengths-of-stay (LOS) spanning 8-12 days, post-operative complication (POC) rates approaching 30 percent and 30-day readmission rates of 15 percent, colorectal operations account for nearly 25 percent of all complications in general surgery. African American patients have even worse outcomes with higher mortality, longer length-of-stays (LOS) and more readmissions. The factors that would reduce these inequities are unknown, which exposes a major gap in our understanding of surgical disparities and our ability to reduce them.
Enhanced Recovery After Surgery (ERAS) pathways link multimodal perioperative processes (e.g., patient education, early mobilization, non-opioid pain regimens, etc.) into a fully integrated package to reduce LOS, POCs and readmissions for patients after colorectal surgery. However, the adoption of ERAS in the United States is inconsistent and its effect on surgical disparities is unclear.
Our research group is interested in identifying, understanding and reducing disparities in surgery. ERAS is a model through which we may better understand mechanisms of disparities at the patient, provider and healthcare system levels. Our team uses both quantitative (big data, clinical registries, etc.) and qualitative (focus groups, interviews, etc.) methods to help address these questions. Ultimately, these research findings will be used to improve the care for all surgical patients.