Original Articles

Effects of Health Disparities on Survival after Neonatal Heart Surgery: Why Should Racial, Ethnic, Gender, and Socioeconomic Status Be Included in the Risk Analysis?

Address correspondence to: Joseph J. Sistino, MS, MPA, CCP, Medical University of South Carolina, 151B Rutledge Avenue, Charleston, SC 29425. E-mail: sistinoj@musc.edu

Received: 18 April 2011
Accepted: 18 November 2011

Abstract

Health disparities are “differences in the quality of health and health care across different populations.” Potential disparities associated with race, ethnicity, gender, and socioeconomic status should be considered when attempting to develop models for survival and neurodevelopmental outcomes in neonates undergoing congenital heart surgery. Each of the aforementioned sociodemographic factors is related to postsurgical mortality because they are frequently linked to measures of access to care in addition to location of care (geographically) and the type of institution (teaching vs. nonteaching) where patients receive care. Traditionally these factors have not been considered in models of surgical treatment outcomes in conditions such as hypoplastic left heart syndrome. However, we believe these factors should at least be included in risk analysis models to help explain their impact on outcomes and in predicting outcomes. Therefore, the purpose of this article is to highlight some of the nonsurgical influences that affect survival after neonatal heart surgery such as race, ethnicity, gender, and socioeconomic status.