ArticleThe American surgeon2026
Bypass of Local Surgical Care in North Carolina: Patient-Directed Care Destination and Utilization.
Article in The American surgeon, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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4 authors.
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Abstract
BackgroundAlthough frequent, patient bypass of local surgical care (bypass) remains understudied. No prior work has evaluated the association between bypass and local surgeon workforce density.MethodsThis is a retrospective cohort study of North Carolina patient bypass (receiving care at a hospital ≥ 10 miles farther from the nearest surgery-capable hospital) from 2016 to 2019 for urgent/emergent surgery. The association between bypass and clinical, sociodemographic, and NSH characteristics was estimated using logistic regression.Results23.7% of patients (n = 9864) bypassed local surgical care. These patients traveled further for care (median miles 25.8 vs 7.4). Living in counties with the lowest general surgeon workforce density (aOR: 1.58, 95% CI: 1.16, 2.16) and second lowest workforce density (aOR: 1.55, 95% CI: 1.26, 1.90) was associated with bypass.DiscussionApproximately 25% of patients undergoing urgent/emergent general surgeries bypassed their nearest surgical care. Patients in counties with lower workforce density were more likely to bypass the nearest surgical hospital.
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