ArticleAnnals of surgery2024
Trends in Timely Access to High-Quality and Affordable Surgical Care in the United States.
Article in Annals of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of the Lancet Commission on Global Surgery indicators with quality assessment of modelled estimates.The British journal of surgery · 2026Pooled it
- Rural Residence and Postsurgical Outcomes Among Medicare Beneficiaries.JAMA network open · 2026Article
- Disparities Across Race, Ethnicity, and Rurality Among Surgical Patients.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Trauma and emergency surgical care at rural emergency hospital-eligible facilities: Interstate variation and policy implications for rural health systems.The journal of trauma and acute care surgery · 2026Article
- Return to farming after orthopedic surgery: A systematic review.World journal of orthopedics · 2026Article
- Financial Hardship After Surgical Procedures.JAMA surgery · 2026Article
- National Medical Expenditures Associated With Surgical Care Among Individuals in the United States.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Changes in surgical quality and access after rural hospital closures.Health affairs scholar · 2025Article
- Service Changes, Utilization, and Financial Performance After Critical Access Hospitals Join Hospital Systems.Cureus · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveTo quantify recent trends in access to timely, high-quality, affordable surgical care in the US.
backgroundInsufficient access to surgical care remains an ongoing concern in the US. Previous attempts to understand and quantify barriers in access to surgical care in the US lack a comprehensive, policy-relevant lens.
methodsThis observational cross-sectional study evaluates multiple domains of access to surgical care across the US from 2011-2015 and 2016-2020. Our stepwise model included timeliness (<60-minute drive time), quality (surgically capable hospital with ≥3 CMS stars), and affordability (neither uninsured nor underinsured) of access to surgical care using a novel combination of data from the American Hospital Association, Medicare claims, CMS's Five-Star Quality Rating System, the American Community Survey, and the Medical Expenditure Panel Survey.
resultsThe number of Americans lacking access to timely, high-quality, affordable surgical care increased from 97.7 million in 2010-2015 to 98.7 million in 2016-2020. Comparing these two periods, we found improvements in the number of Americans lacking access due to being uninsured (decrease from 38.5 to 26.5 million). However, these improvements were offset by increasing numbers of Americans for whom timeliness (increase from 9.5 to 14.1 million), quality (increase from 3.4 to 4.9 million), and underinsured status (increase from 46.3 to 53.1 million) increased as barriers to access. Multiple sensitivity analyses using alternative thresholds for each access domain demonstrated similar trends. Those with insufficient access to care tended to be more rural (6.7% vs. 2.0%, P<0.001), lower income (40.7% vs. 30.0%, P<0.001), and of Hispanic ethnicity (35.9% vs. 15.8%, P<0.001).
conclusionsNearly one-in-three Americans lack access to surgical care that is timely, high-quality, and affordable. This study identifies the multiple actionable drivers of access to surgical care that notably can each be addressed with specific policy interventions.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.