Population demographics in geographic proximity to hospitals with robotic platforms do not correlate with disparities in
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and Other Interventional Techniques
2020 SAGES POSTER
Population demographics in geographic proximity to hospitals with robotic platforms do not correlate with disparities in access to robotic surgery Katherine Bingmer1 · Maher Kazimi2 · Victoria Wang3 · Asya Ofshteyn1 · Emily Steinhagen1 · Sharon L. Stein1 Received: 13 May 2020 / Accepted: 27 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Disparities in access to robotic surgery have been shown on the local, regional, and national level. This study aims to see if the location of hospitals with robotic platforms (HWR) correlates with population trends to explain the disparity in access to robotic surgery. Methods Hospitals with da Vinci surgical systems were identified by compiling data from the publicly available da Vinci surgeon locator website. Demographic, and economic data were compiled. Multivariate logistic regression and place-based analysis were used to determine population characteristics associated with geographic proximity to HWR. Results The United States has 1971 HWR (5.93 hospitals with robots per 1 million people). The states with the most HWR are Texas (203), California (175), and Florida (162). Multivariate logistic regression analysis of Texas counties determined population (OR 1.97, 95% CI 1.40–3.38) education level (OR 1.64, 95% CI 1.07–3.21), and urban designation (OR 1.15, 95% CI 1.05–1.31) remained significantly associated with HWR. When applied to a national level, population remained associated with higher numbers of HWR (R = 0.945), however level of education and urbanization were not. Conclusions Based on this study of population-level data, disparities in access to robotic surgery seen in prior literature cannot be explained exclusively by sociodemographic factors related to the geographic proximity of HWR. This suggests other biases are involved in the lack of robotic procedures performed among minority and underprivileged populations. Keywords Robotic surgery · Healthcare disparities · Surgical disparities · Place-based analysis · Minimally invasive surgery Minimally invasive surgery has been shown to result in superior short-term outcomes in many specialties [1, 2]. A growing proportion of minimally invasive surgery is being Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00464-020-07961-2) contains supplementary material, which is available to authorized users. * Sharon L. Stein [email protected] 1
Department of Surgery, UH‑RISES, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH 44106, USA
2
Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA
3
Case Western Reserve University School of Medicine, Cleveland, OH, USA
performed robotically [3–8]. Prior studies have revealed that certain socioeconomic groups may have decreased access to robot surgery [9]. In attempting to elucidat
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