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Special Communication
June 2016

Setting a National Agenda for Surgical Disparities Research: Recommendations From the National Institutes of Health and American College of Surgeons Summit

Author Affiliations
  • 1Center for Surgery and Public Health, Harvard Medical School and Harvard T. H. Chan School of Public Health, Boston, Massachusetts
  • 2Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
  • 3National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland
  • 4Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
  • 5Department of General Pediatric Surgery, Children’s Hospital Los Angeles, University of Southern California, Los Angeles
  • 6Department of Surgery, Albany Medical College, Albany, New York
  • 7Office of Chief Quality Officer, Baylor Scott and White Health System, Dallas, Texas
  • 8Division of General Surgery, United Regional Hospital, Kell West Regional Hospital, Wichita Falls, Texas
  • 9American College of Surgeons, Chicago, Illinois
  • 10National Institutes of Health, Bethesda, Maryland
  • 11Department of Surgery, Eastern Virginia Medical School, Norfolk
JAMA Surg. 2016;151(6):554-563. doi:10.1001/jamasurg.2016.0014

Health care disparities (differential access, care, and outcomes owing to factors such as race/ethnicity) are widely established. Compared with other groups, African American individuals have an increased mortality risk across multiple surgical procedures. Gender, sexual orientation, age, and geographic disparities are also well documented. Further research is needed to mitigate these inequities. To do so, the American College of Surgeons and the National Institutes of Health–National Institute of Minority Health and Disparities convened a research summit to develop a national surgical disparities research agenda and funding priorities. Sixty leading researchers and clinicians gathered in May 2015 for a 2-day summit. First, literature on surgical disparities was presented within 5 themes: (1) clinician, (2) patient, (3) systemic/access, (4) clinical quality, and (5) postoperative care and rehabilitation-related factors. These themes were identified via an exhaustive preconference literature review and guided the summit and its interactive consensus-building exercises. After individual thematic presentations, attendees contributed research priorities for each theme. Suggestions were collated, refined, and prioritized during the latter half of the summit. Breakout sessions yielded 3 to 5 top research priorities by theme. Overall priorities, regardless of theme, included improving patient-clinician communication, fostering engagement and community outreach by using technology, improving care at facilities with a higher proportion of minority patients, evaluating the longer-term effect of acute intervention and rehabilitation support, and improving patient centeredness by identifying expectations for recovery. The National Institutes of Health and American College of Surgeons Summit on Surgical Disparities Research succeeded in identifying a comprehensive research agenda. Future research and funding priorities should prioritize patients’ care perspectives, workforce diversification and training, and systematic evaluation of health technologies to reduce surgical disparities.

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