Gaps in Emergency General Surgery Coverage in the United States. Issue 1 (18th March 2021)

• Record Type: Journal Article
• Authors: Ingraham, Angela M.; Chaffee, Scott M.; Ayturk, M. Didem; Heh, Victor K.; Kiefe, Catarina I.; Santry, Heena P.
• Is Part Of: Annals of surgery open. Volume 2:Issue 1(2021)
• Page Start: e043
• Publication Date: 2021-03-18
• Subjects: Surgery -- Periodicals; Surgery -- History -- Periodicals; General Surgery; Surgery; History; Periodicals; 616
• DOI: 10.1097/AS9.0000000000000043
• Languages: English
• ISSNs: 2691-3593

Abstract

Abstract : 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. Abstract : Mini-abstract: Gaps in Emergency General Surgery Coverage in the United States is a national survey-based research study that highlights the presence of significant gaps in emergency general surgery (EGS) care. The surveyed population was determined using the 2013 American Hospital Association Annual Survey of US hospitals to identify acute care general hospital accessible to the general public and presence of an emergency room and at least one operating room. Survey results indicate gaps in round-the-clock EGS care exist in the United States. The declining general surgery workforce presents a substantial reason for hospitals' inability to provide round-the-clock EGS care. Supplemental Digital Content is available in the text.