ethnicity and race variations in receipt of surgery among veterans with and without depression

To examine equity in one aspect of care provision in the Veterans Health Administration, this study analyzed factors associated with receipt of coronary artery bypass graft (CABG), vascular, hip/knee, or digestive system surgeries during FY2006–2009. A random sample of patients (N=317,072) included 9% with depression, 17% African-American patients, 5% Hispanics, and 5% women. In the four-year followup, 18,334 patients (6%) experienced surgery: 3,109 hip/knee, 3,755 digestive, 1,899 CABG, and 11,330 vascular operations. Patients with preexisting depression were less likely to have surgery than nondepressed patients (4% versus 6%). In covariate-adjusted analyses, minority patients were slightly less likely to receive vascular operations compared to white patients (Hispanic OR=0.88, P<.01 ; African-American OR=0.93, P<.01) but more likely to undergo digestive system procedures. Some race-/ethnicity-related disparities of care for cardiovascular disease may persist for veterans using the VHA.