Postoperative Outcomes in the Plain Community Population of Western Wisconsin

Abstract

Background

Residents of plain communities constitute an underserved minority population that is not reliably captured in contemporary surgical outcomes research. We hypothesized that plain communities (PC) patients would have higher postoperative complication rates than a general surgical population.

Methods

A retrospective review of 30-day postoperative outcomes for PC patients compared to a majority (non-PC) matched patient population from September 2014 to March 2020 was performed. The primary outcome measure was any complication within 30 days of surgery.

Results

270 PC patients were matched with 493 non-PC patients. The 30-day complication rate was higher for the PC group (6.3% vs 3.7%, P = .09), though not statistically significant. There was significantly lower utilization of preventive care services, and postoperative follow-up among PC patients.

Discussion

Although our regional PC surgical patient population utilized preventive and postoperative health care services less than the non-PC population, there was no statistically significant difference in overall 30-day postoperative morbidity or mortality.

Keywords

plain community preventive care postoperative outcomes minority population surgical complications health disparities

Get full access to this article

View all access options for this article.

References

Institute of Medicine (US) . Committee on understanding and eliminating racial and ethnic disparities in health care. In: Smedley

Stith

Nelson

, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington, DC: National Academies Press (US); 2003.

U.S. Dept. of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Planning and Evaluation and Office of Minority Health . HHS Action Plan to Reduce Racial and Ethnic Health Disparities Implementation Progress Report. Washington, DC: Office of the Assistant Secretary for Planning and Evaluation; 2015.

Cates

. Serving the Amish: A Cultural Guide for Professionals. Baltimore, MD: Johns Hopkins University Press; 2014:5-6.

Amish Population Change 2000-2020 . Young Center for Anabaptist and Pietist Studies, Elizabethtown College. https://groups.etown.edu/amishstudies/files/2020/08/Population_Change_2000-2020.pdf. Accessed January 31, 2022.

Young Center for Anabaptist and Pietist Studies, Elizabethtown College . Twelve Largest Amish Settlements. 2021. http://groups.etown.edu/amishstudies/statistics/twelve-largest-settlements-2021/. Accessed January 31, 2022.

Young Center for Anabaptist and Pietist Studies, Elizabethtown College . Amish Population Change 2010-2019. https://groups.etown.edu/amishstudies/files/2019/07/Population_Change_2010-2019.pdf. Accessed January 31, 2022.

Annual Estimates of the Resident Population by Sex, Race, and Hispanic origin for the United States: April 1, 2010 to July 1, 2019 (NC-EST2019-SR11H), U.S. Census Bureau, Population Division; 2020. https://www.census.gov/newsroom/press-kits/2020/population-estimates-detailed.html. Accessed 13 October 2020.

Cates

. Serving the Amish: A Cultural Guide for Professionals. Baltimore, MD: Johns Hopkins University Press; 2014:191.

Weyer

Hustey

Rathbun

, et al.

A look into the Amish culture: What should we learn?

J Transcult Nurs. 2003;14(2):139-145. doi:10.1177/1043659602250639

10.

Rohr

Spears

Geske

Khandalavala

Lacey

. Utilization of health care resources by the Amish of a rural county in Nebraska. J Community Health. 2019;44(6):1090-1097. doi:10.1007/s10900-019-00696-9

11.

Rohrer

Dundes

. Sharing the load: Amish health care financing. Healthcare. 2016;4(4):92. doi:10.3390/healthcare4040092

12.

Westman

Ferketich

Kauffman

, et al. Low cancer incidence rates in Ohio Amish. Cancer Causes Control. 2010;21(1):69-75. doi:10.1007/s10552-009-9435-7

13.

Morton

Strauss

, et al. Pediatric medicine and the genetic disorders of the Amish and Mennonite people of Pennsylvania. Am J Med Genet C Semin Med Genet. 2003;121C(1):5-17. doi:10.1002/ajmg.c.20002

14.

Mitchell

Lee

Tolea

, et al. Living the good life? Mortality and hospital utilization patterns in the old order Amish. PLoS One. 2012;7(12):e51560. doi:10.1371/journal.pone.0051560

15.

Schroeder

. The Health Beliefs and Practices of the Amish. Clinical Field Paper, Oshkosh, WI: University of Wisconsin – Oshkosh; 2010.

16.

Sieren

Grow

GoodSmith

, et al. Cross-sectional survey on newborn screening in Wisconsin Amish and Mennonite communities. J Community Health. 2016;41(2):282-288. doi:10.1007/s10900-015-0094-1

17.

Payne

Rupar

Siu

. Amish, Mennonite, and Hutterite genetic disorder database. Paediatr Child Health. 2011;16(3):e23-e24. doi:10.1093/pch/16.3.e23

18.

Deline

Varnes-Epstein

Dresang

Gideonsen

Lynch

Frey

3rd . Low primary cesarean rate and high VBAC rate with good outcomes in an Amish birthing center. Ann Fam Med. 2012;10(6):530-537. doi:10.1370/afm.1403

19.

Vitale

Rzucidlo

Shaffer

Ceneviva

Thomas

. The impact of pediatric trauma in the Amish community. J Pediatr. 2006;148(3):359-365. doi:10.1016/j.jpeds.2005.10.036

20.

Katz

Ferketich

Paskett

Bloomfield

. Health literacy among the Amish: Measuring a complex concept among a unique population. J Community Health. 2013;38(4):753-758. doi:10.1007/s10900-013-9675-z