Gaps in Emergency General Surgery Coverage in the United States

Area of Science:

• Surgical Care
• Healthcare Access
• Health Services Research

Background:

• Three million adults in the US require emergency general surgery (EGS) annually.
• Vulnerable populations are disproportionately affected by EGS needs.
• Barriers to continuous EGS care remain poorly understood.

Purpose of the Study:

• To measure existing gaps in 24/7 EGS care across US hospitals.
• To identify factors contributing to the inability to provide continuous EGS services.

Main Methods:

• A survey of US adult acute care general hospitals providing EGS care was conducted.
• Hospitals with emergency rooms and operating rooms were included.
• Surgeons and chief medical officers provided data on EGS practices.

Main Results:

• Over 17% of responding hospitals could not always provide 24/7 EGS care.
• Rural, smaller, non-teaching hospitals were more likely to lack continuous care.
• Inconsistent surgeon coverage was the main barrier, followed by issues with anesthesia and call stipends.

Conclusions:

• Significant disparities exist in accessing 24/7 EGS care.
• Workforce deficiencies are a primary driver of these access gaps.
• Addressing staffing and systemic issues is crucial for improving EGS availability.