Gaps in Emergency General Surgery Coverage in the United States

Introduction:. Despite 3 million adults in the United States being admitted annually for emergency general surgery (EGS) conditions, which disproportionately affect vulnerable populations, we lack an understanding of the barriers to round-the-clock EGS care. Our objective was to measure gaps in roun...

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Bibliographic Details
Main Authors: Angela M. Ingraham, MD, MS, Scott M. Chaffee, BS, M. Didem Ayturk, MS, Victor K. Heh, PhD, Catarina I. Kiefe, MD, PhD, Heena P. Santry, MD, MS
Format: Article
Language:English
Published: Wolters Kluwer Health 2021-03-01
Series:Annals of Surgery Open
Online Access:http://journals.lww.com/10.1097/AS9.0000000000000043
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Summary:Introduction:. Despite 3 million adults in the United States being admitted annually for emergency general surgery (EGS) conditions, which disproportionately affect vulnerable populations, we lack an understanding of the barriers to round-the-clock EGS care. Our objective was to measure gaps in round-the-clock EGS care. Methods:. From August 2015 to December 2015, we surveyed all US-based adult acute care general hospitals that have an emergency room and ≥1 operating room and provided EGS care, utilizing paper and electronic methods. Surgeons or chief medical officers were queried regarding EGS practices. Results:. Of 2811 hospitals, 1634 (58.1%) responded; 279 (17.1%) were unable to always provide round-the-clock EGS care. Rural location, smaller bed size, and nonteaching status were associated with lack of round-the-clock care. Inconsistent surgeon coverage was the primary reason for lacking round-the-clock EGS care (n = 162; 58.1%). However, lack of a tiered system for booking emergency cases, no anesthesia availability overnight, and no stipend for EGS call were also associated with the inability to provide round-the-clock EGS care. Discussion:. We found significant gaps in access to EGS care, often attributable to workforce deficiencies.
ISSN:2691-3593