de Jager, Elzerie, Levine, Adele A., Udyavar, N. Rhea, Burstin, Helen R., Bhulani, Nizar, Hoyt, David B., Ko, Clifford Y., Weissman, Joel S., Britt, L.D., Haider, Adil H., and Maggard-Gibbons, Melinda A. (2019) Disparities in surgical access: a systematic literature review, conceptual model, and evidence map. Journal of the American College of Surgeons, 228 (3). pp. 276-298.

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Abstract

[Extract] Healthcare disparities in quality represent one of the greatest challenges in achieving uniformly high-quality care. Research reporting disparities in surgical outcomes are abundant. The cornerstone of delivering high-quality healthcare is ensuring optimal access for all patients. A relative lack of access to surgical services might be a contributing factor to disparities in surgical outcomes.

Access is "the timely use of personal health services to achieve the best possible outcomes." Use of services, the process of entering and staying in the system, and the actual quality of care received are all involved. Disparities in access arise when the system disproportionately underperforms for a specific group of patients relative to the historically advantaged population.8, 9 Surgery, because of its time sensitive, often high-acuity nature, is greatly dependent on access.

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