Levine, Adele A., De Jager, Elzerie, and Britt, L.D. (2020) Perspective: identifying and addressing disparities in surgical access: a health systems call to action. Annals of Surgery, 271 (3). pp. 427-430.

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Abstract

As surgical quality improvement programs proliferate, we must return to 1 of the central tenets of the National Institute of Health—American College of Surgeons (ACS) Symposium on Surgical Disparities Research: “No quality without access.” Disparities across the continuum of surgical care also extend to access to surgical care. A 2019 systematic literature review of studies conducted in the United States identified 223 surgical access study outcomes with demonstrated disparities across a surgical access framework: Provider Access, Surgical Indication Detection, Progression to Surgery, or Optimal Care Capacity.1 To compare these potential quality measures with existing surgical performance measures, this framework was applied to an environmental scan of measure repositories and survey of quality experts, returning only 16 validated measures of surgical access. This critical gap is a clear charge for health systems to mitigate population-level disparities in surgical care by incorporating surgical access measures.

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