Same-day discharge after anterior cervical discectomy and fusion (ACDF) is becoming increasingly common, but whether discharge outcomes differ by race or sex remains unclear. We performed a retrospective cohort study of 19,240 ACDF patients from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) between 2023 and 2024. Primary outcomes were same-day discharge, non-home discharge, and unplanned 30-day readmission. After adjusting for age, comorbidities, and operative characteristics, females had lower odds of same-day discharge (aOR 0.74, 95% CI 0.68-0.81, p < 0.001) and readmission (aOR 0.77, 95% CI 0.66-0.91, p = 0.002) compared with males. Compared with White patients, Black patients had lower adjusted odds of same-day discharge (aOR 0.70, 95% CI 0.61-0.80, p < 0.001) and higher adjusted odds of non-home discharge (aOR 2.45, 95% CI 2.08-2.87, p < 0.001) and readmission (aOR 1.37, 95% CI 1.10-1.69, p = 0.004). Race- and sex-associated differences showed distinct patterns, suggesting standardized discharge planning and equitable access to same-day discharge may help reduce disparities in post-ACDF care transitions.

Black patients experience substantially lower pre-emptive kidney transplant rates than White patients, possibly attributable to the prior use of race-based eGFR equations that delayed transplant eligibility and limited waiting time accrual. We evaluated the 2023 Organ Procurement and Transplantation Network (OPTN) waiting time policy providing retroactive credits to affected Black patients. Using OPTN data (2021-2025), we analyzed 39,437 waitlist candidates and 26,001 transplant recipients. We quantified changes in racial disparities using multivariable logistic regression with race-by-policy interaction terms and stratified by Area Deprivation Index. The disparity in pre-emptive transplantation odds between Black and White patients significantly decreased from 46% pre-policy to 19% post-policy. Pre-emptive transplant rates doubled among Black patients (7.6% to 15.3%) but remained lower than those of White patients (28.0%). Policy benefits reached Black patients equitably across neighborhood-level socioeconomic status. The policy change achieved measurable reductions in racial disparities, though persistent gaps indicate allocation policy reforms alone are likely insufficient.