Community-based health preferences for proctocolectomy: a race comparison

Abstract

Our objective was to determine whether there are dominating racial differences in patient preferences for surgery that may explain the disparities in proctocolectomy utilization between African Americans (AA) and whites. We used the time trade-off technique to measure health preferences for undergoing ileal pouch anal anastomosis (IPAA) and ileostomy among a community sample of 23 white and 16 AA participants who were unaffected by colorectal disease. Our results show that African Americans were similar to whites with respect to baseline quality of life and comorbidities. There were no differences in health utility ratings for IPAA between AA and whites (0.49 +/- 0.34 vs 0.51 +/- 0.31, P = 0.95). The health preference for ileostomy among AA (0.52 +/- 0.32) was also similar to that in whites (0.54 +/- 0.32). We conclude that patient preferences for proctocolectomy are unlikely to be a dominant contributing factor to racial disparities in total proctocolectomy for diseases of the colon.