de Jager, Elzerie, Osman, Samia Y., Levine, Adele A., Liu, Charles, Maggard Gibbons, Melinda A., Ko, Clifford Y., Burstin, Helen R., Haider, Adil H., Hoyt, David B., Schoenfeld, Andrew J., Britt, L.D., and Weissman, Joel S. (2023) Disparity-Sensitive Measures in Surgical Care: A Delphi Panel Consensus. Journal of the American College of Surgeons, 236 (1). pp. 135-143.

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Abstract

Background: In the US, disparities in surgical care impede the delivery of uniformly high-quality care to all patients. There is a lack of disparity-sensitive measures related to surgical care. The American College of Surgeons Metrics for Equitable Access and Care in Surgery group, through research and expert consensus, aimed to identify disparity-sensitive measures in surgical care.

Study Design: An environmental scan, systematic literature review, and subspecialty society surveys were conducted to identify potential disparity-sensitive surgical measures. A modified Delphi process was conducted where panelists rated measures on both importance and validity. In addition, a novel literature-based disparity-sensitive scoring process was used.

Results: We identified 841 potential disparity-sensitive surgical measures. From these, our Delphi and literature-based approaches yielded a consensus list of 125 candidate disparity-sensitive measures. These measures were rated as both valid and important and were supported by the existing literature.

Conclusion: There are profound disparities in surgical care within the US healthcare system. A multidisciplinary Delphi panel identified 125 potential disparity-sensitive surgical measures that could be used to track health disparities, evaluate the impact of focused interventions, and reduce healthcare inequity.

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