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Invited Commentary
July 2013

Why Do Nonwhite Patients Undergo Amputation More Commonly Than White Patients?

Author Affiliations
  • 1Division of Vascular Surgery, University of South Florida Health, Morsani College of Medicine, Tampa, Florida
JAMA Surg. 2013;148(7):623. doi:10.1001/jamasurg.2013.1450

There is a compelling amount of data showing that amputation and revascularization rates between white and nonwhite patients are different. What accounts for this? The current analysis suggests that access to care, socioeconomic status, and clinical category of disease at presentation do not account for such differences.1 In their discussion, the authors suggest 3 general factors to consider: (1) differing access to care, (2) patient factors such as noncompliance, and (3) physician factors including bias and prejudice; however, they ultimately cite reasonably good arguments against most. Nowhere do they claim that health care provider bias is the reason, but this seems to be the only factor that cannot be excluded.

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