Even if insurance and household incomes are similar, white people are more likely than people of color to be sent home after surgery rather than to a skilled nursing facility. People of color are also more likely to stay in long-term care or get care at home, according to results presented at the ANESTHESIOLOGY 2021 annual meeting.

The reason, the authors believe, it is that people of color are more likely to have severe diabetes and high blood pressure, which can impact recovery. 

This study is the first project of the Health Outcomes and Perioperative Equity (H.O.P.E.) group of Massachusetts General Hospital, Beth Israel Deaconess Medical Center, and Montefiore Medical Center whose members analyzed the records of 378,747 patients who had non-cardiac surgery between January 2008 and February 2020 at two Boston hospitals, 38,911 of whom were non-Latino Black and 339,836 of whom were non-Latino white.

They found 7.5% of Black and 6.9% of white patients who had been living at home were discharged to a skilled nursing facility after surgery, instead of returning home. This means Black patients were 1.5 times less likely than white patients to live independently after surgery. They also found 12.3% of Black patients had severe diabetes vs. 5.1% of white patients, and 43.8% of Black patients had high blood pressure vs. 32.8% of white patients before surgery. Overall, 34.6% of the effect of race on postoperative loss of the ability to live independently was explained by patients having severe diabetes or high blood pressure before surgery.

Black patients with severe diabetes and high blood pressure also were 1.5 times less likely to live independently after surgery than Black patients who didn’t have these conditions, the authors note.