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Association Between Surgical Robotic Availability and Open Operation Rate: A Geographic Analysis.

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Geographic access to robotic surgery systems is linked to lower open surgery rates, especially in areas with high social vulnerability. This study highlights disparities in surgical access and outcomes.

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Area of Science:

  • Health Services Research
  • Surgical Technology
  • Geographic Health Disparities

Background:

  • Minimally invasive surgery adoption varies across the U.S., with persistent disparities.
  • Geographic access to robotic surgical systems is an understudied factor in these disparities.
  • Social vulnerability and robotic system availability may influence surgical approach selection.

Purpose of the Study:

  • To evaluate the geospatial association between social vulnerability index (SVI) and open surgery rates.
  • To assess the relationship between robotic system availability and open surgery rates.
  • To compare open surgery rates in demographically similar areas with differing robotic access.

Main Methods:

  • Data from six sources were linked at the ZIP Code Tract Area (ZCTA) level.
  • Regression analysis assessed the association between SVI and open surgery rates.
  • Propensity score matching compared open rates across matched ZCTAs by robotic access and SVI levels.

Main Results:

  • Higher SVI correlated with increased open surgery rates (18.3% low vs. 32.7% high vulnerability).
  • ZCTAs without robotic systems had significantly higher open surgery rates (42.9 vs. 19.4 per 100 procedures).
  • This association persisted after matching for SVI and robotic access.

Conclusions:

  • Robotic surgery availability is linked to decreased open surgery rates when accounting for geographic variation.
  • Addressing geographic disparities in robotic system access may reduce open surgery rates.
  • Findings underscore the importance of equitable access to advanced surgical technologies.