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Population demographics in geographic proximity to hospitals with robotic platforms do not correlate with disparities in access to robotic surgery

  • 2020 SAGES Poster
  • Published:
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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.

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Authors and Affiliations

  1. Department of Surgery, UH-RISES, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, LKS 5047, Cleveland, OH, 44106, USA

    Katherine Bingmer, Asya Ofshteyn, Emily Steinhagen & Sharon L. Stein

  2. Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Maher Kazimi

  3. Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Victoria Wang

Authors
  1. Katherine Bingmer
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  2. Maher Kazimi
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  3. Victoria Wang
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  4. Asya Ofshteyn
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  5. Emily Steinhagen
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  6. Sharon L. Stein
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Corresponding author

Correspondence to Sharon L. Stein.

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Disclosures

Dr. Stein is a consultant for Merck Sharp and Medtronics. Drs. Bingmer, Ofshteyn, and Steinhagen, Mr. Kazimi, and Ms. Wang have no conflicts of interest to report.

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Bingmer, K., Kazimi, M., Wang, V. et al. Population demographics in geographic proximity to hospitals with robotic platforms do not correlate with disparities in access to robotic surgery. Surg Endosc 35, 4834–4839 (2021). https://doi.org/10.1007/s00464-020-07961-2

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  • DOI: https://doi.org/10.1007/s00464-020-07961-2

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