American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Statement on Optimal Access

The American College of Surgeons Regental Committee on Optimal Access developed the following statement. The Board of Regents approved the statement at their February 8–9, 2013, meeting in Chicago, IL.

The American College of Surgeons recognizes the critical relationship between the health of a patient and access to care. This association is strongly documented with respect to conditions requiring surgical care specifically, including interventions for trauma, cancer, heart, and vascular disease, renal disease, and other correctable conditions that interfere with normal development, employment, and independent living.

Access to surgical care is affected by socioeconomic status, age, gender, level of education, race, ethnicity, health care availability, and geographic distance. While insurance status proves to be the most reliable surrogate for prediction of outcome differences, underuse, and delay of surgery, rural location and limited access to high volume hospitals are additional mechanisms that lead to inequities in surgical outcomes. Despite these factors, several studies have shown that where access to care is equal outcome disparities become indiscernible.

Optimal access is the key to quality of care. Efforts to increase surgical presence and availability are crucial to providing the right care, at the right time, in the right place. Optimal quality, the centerpiece of the mission of the American College of Surgeons, is not achievable without optimal access.

Haider AH, Scott VK, Rehman KA, Velopulos C, Bentley JM, Cornwell EE, Al-Refaie W. Racial disparities in surgical care and outcomes in the United Sates: A comprehensive review of patient, provider and systemic factors. J Am Coll Surg. 2013;216(3):482-492.