Presentation (CTI)

OBJECTIVES: As healthcare systems evolve, there is an increasing importance for regulatory bodies to evaluate health equity within the context of medical devices. The aim of this analysis is to review and synthesize literature on health disparities for patients undergoing robotic-assisted surgery (RAS).
METHODS: We conducted a literature search using PubMed, Embase, and Scopus databases for studies published between January 1, 2019 and May 16, 2024 that discussed the linkage between RAS and health disparities in patient populations. Disparities were grouped into domains, including age, sex, gender, race/ethnicity, education, geography, socioeconomic income, and payor status. We extracted the number of studies containing clinical outcomes (such as, length of stay), equity-based outcomes (such as, the odds of receiving minimally invasive surgery), or both. Additionally, we identified studies that were intersectional and reported on multiple disparity domains.
RESULTS: Our search resulted in 112 studies, with 87 of those having original and extractable data. The most frequent disparity domain reported in the literature was race/ethnicity (N=54), followed by payor status (N=20) and geography (N=16). Most papers reported solely clinical outcomes (N=48) among patients, with few (N=5) containing both clinical and equity-based outcomes. 24 studies included intersectional analyses. Patients who had lower access to RAS included those who were black, on Medicare, Medicaid, or were uninsured, and lived in rural geographies.
CONCLUSIONS: Our results demonstrate that the most reported disparity in the body of literature on RAS and health equity was race/ethnicity. More research is needed to examine the intersectional nature of disparities. Additionally, more studies on the relationship between other disparity domains and RAS are also needed.