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Patients were identified from the Healthcare Utilization Project National Inpatient Sample (HCUP-NIS) for the years 1998-2002. The HCUP-NIS is a national, population-based sample representing 20% of hospital discharges annually in the United States and is prepared by the Agency for Healthcare Research and Quality. The number of states contributing data ranged from 22 states in 1998 to 35 states in 2002.
- In: Health
- Tags: hysterectomy, leiomyoma, myomectomy, race/ethnicity, uterine fibroid
Inpatient Surgical Treatment Patterns
14 Nov2009
INTRODUCTION
Uterine leiomyomas (fibroids) are benign, often asymptomatic tumors derived from smooth muscles and the extracellular matrix proteins collagen and elastin. Signs and symptoms of uterine fibroids include heavy or prolonged menstrual bleeding, pain and pregnancy complications. Although patients with benign symptoms may be monitored without treatment, common surgical treatments include hysterectomy (abdominal, vaginal and laparoscopic) and myomectomy (laparotomy, laparoscopic and hystero-scopic). New approaches, such as myolysis, focused ultrasound, transvaginal cryomyolysis and uterine artery embolization (UAE), are being studied as possible alternative treatments. Uterine fibroids have been identified as the most common diagnosis associated with hysterectomy in the United States.
- In: Health
- Tags: hysterectomy, leiomyoma, myomectomy, race/ethnicity, uterine fibroid
With the current low attrition rates from medical school, nearly every student who enters medical school will become licensed to practice, meaning that medical school admissions committees have the sole responsibility of choosing the nation’s future physician workforce. Our study examining the perception of medical schools on barriers to URM recruitment sheds some light on how schools make admission decisions and how this affects diversity in the classroom. For example, low GPA and MCAT scores among URM applicants are perceived to be a barrier by the vast majority of respondents, suggesting that schools continue to place significant weight on these admissions criteria.
The overall response rate was 59% (86 out of 144), which compares favorably with the 41% response rate obtained by Dinan et. al. in their medical school survey. Our response rate did not differ by geographic region but was higher among osteopathic schools than allopathic schools (68% versus 55%, P<0.05). Of the responding institutions, 50 identified themselves as public and 28 as private; eight schools did not respond to this survey question. Among the 60 schools responding to the question on the percentage of entering students who were URM, the mean was 10.4% (median 10.0, inter-quartile range 6-15%). This figure is similar to the 10.9% URM enrollment at all U.S. medical schools in 2001 . The mean percentage of URM did not differ significantly among private schools versus public schools or at osteopathic versus allopathic schools. Phone contact with nonresponding schools found that that lack of time or staff resources to fill out the survey by the deadline was the most common reason for lack of participation. However, two schools expressed concern that providing data on this topic would leave them legally vulnerable.
Instrument Development
In developing the American Medical Student Association Diversity Survey (AMSA-DS), we first conducted a review of the relevant literature using a Medline search for combinations of the following key words: “underrepresented minorities,” “medical school admissions,” “diversity,” “recruitment,” “retention” and “representation.” Included were all articles, both research studies and commentary, published between 1985 and 2000 and having any discussion of minority representation in medical schools. A summary of the findings in these articles with an annotated bibliography were presented to AMSA’s Diversity Coalition, a group of eight membership-based medical associations with a stated commitment to diversity in their mission statement (Table 1). Representatives of these organizations drafted the AMSA-DS. In the fall of 2001, the instrument was pilot-tested at four medical schools. The deans of students at each of these schools were asked to comment on content, length and clarity of the survey and survey items. Based on their feedback, the instrument was revised by modifying some questions, adding certain items and excluding other questions. The final survey contained 100 items and took approximately 20 minutes to complete [instrument available from Carrasquillo (author)]. Survey items included:
BACKGROUND
Despite nearly a quarter century of diversity initiatives by government agencies, medical schools and other organizations, the percentage of medical students who belong to historically underrepresented racial and ethnic minority (URM) groups has remained fairly uniform, fluctuating from 8.0% to 12.5%/ while representation of these same minority groups—African Americans, Hispanic Americans and Native Americans—in the U.S. population has reached 26% and continues to grow.
This study used the PPOR model to categorize fetal and infant deaths in New York City, describe racial/ethnic disparities and guide interventions. During 1996-2000, the average feto-infant mortality rate was 11.5/1,000 live births plus fetal deaths for the city. Statistically significant racial/ethnic differences in feto-infant mortality were found with black non-Hispanic women experiencing a much higher rate of feto-infant mortality compared to other groups.