Unveiling Equitable Surgical Prioritization: Insights From a Comprehensive Analysis Using the Medically Necessary and...

Area of Science:

• Healthcare disparities
• Surgical prioritization
• Medical decision-making

Background:

• Racial disparities in surgical care are a significant concern, exacerbated by pandemic-related resource scarcity.
• Provider bias can influence medical decision-making, impacting equitable access to procedures.
• The American College of Surgeons developed the Medically Necessary and Time-Sensitive (MeNTS) scoring system to standardize prioritization for non-emergent, but necessary, surgeries.

Purpose of the Study:

• To evaluate the effectiveness of the MeNTS scoring system in reducing racial disparities in surgical prioritization.
• To analyze whether the implementation of the MeNTS system impacted the time to surgery across different racial and ethnic groups during the COVID-19 pandemic.

Main Methods:

• A retrospective cross-sectional study analyzed Electronic Medical Records from June 1, 2020, to December 31, 2021.
• Bivariate and multivariate analyses were used to examine variations in MeNTS scores and time to surgery based on patient race and ethnicity.
• The study included 2,997 patients from diverse racial and ethnic backgrounds.

Main Results:

• No statistically significant differences in mean days to surgery or MeNTS scores were observed across racial and ethnic groups.
• A multivariate survival model indicated that lower MeNTS scores (below 30) were associated with a higher likelihood of receiving surgery.
• The analysis found no significant disparities in surgery likelihood based on race, ethnicity, or gender when using the MeNTS system.

Conclusions:

• The MeNTS scoring system demonstrated an absence of statistically significant racial disparities in surgical prioritization.
• These findings suggest that standardized scoring systems can be effective tools in mitigating potential biases in medical decision-making.
• The study contributes valuable insights into promoting equitable healthcare practices within surgical settings.