The National Institute on Minority Health and Health Disparities (NIMHD) in collaboration with the American College of Surgeons (ACS) hosted a State of the Science meeting May 7–8, 2015, in Bethesda, MD, to assess the current state of the science and develop goals for conducting meaningful research addressing the disparities in surgical care, outcomes, and treatment.
The intended outcome for this meeting was to determine a set of recommendations to be used by the NIMHD to develop a program announcement focused on surgical disparities research.
Overview of Conference
Participants heard from experts in the field of outcomes disparities with a focus on the five major themes. For each theme, there were presentations from a surgical resident—who provided an overview of current research in that thematic area—and a nonsurgeon expert who provided a broader perspective on the topic. After presentations and discussion, each participant was encouraged to generate a list of research questions and priorities ranked in order of importance.
Co-chairs presented the top research questions for each theme. Following a keynote presentation, small breakout sessions were held to discuss and debate the research questions. Building upon these sessions, the full group of symposium participants participated in a formal, agenda-setting exercise to develop and refine a set of recommendations on national priorities in surgical disparities research.
The Five Major Themes
The discussion sessions during the two-day forum focused on five major cross-cutting themes underlying determinants of disparities in surgical outcomes:
- Patient Factors (i.e., age, demographics, language, socioeconomic status, cultural and social environment, clinical and psychosocial factors, behaviors, patient-provider interactions)
- Systemic Factors and Access Issues (i.e., health care access and insurance status, health system structure, electronic health records, and institutional level policies)
- Clinical Care and Quality (i.e., hospital quality and location, provider volume, patient centeredness, quality improvement strategies, clinical guidelines and protocols)
- Provider Factors (i.e., provider bias, competencies, and awareness, staffed and resourced facilities, supportive hospital policies)
- Post-Operative Care and Rehabilitation (i.e., timing, post-op care and experience, entry point into rehabilitation, and length of rehabilitation)