Paul G Mastrokostas, Leonidas E Mastrokostas, Ahmed K Emara, Jonathan Dalton, Rajkishen Narayanan, Christopher K Kepler, Alan S Hilibrand, Alexander R Vaccaro, Jad Bou Monsef, Afshin E Razi, Mitchell K Ng
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Statistical significance was set at the <i>P</i> < .05 level.ResultsNinety-one robotic spine surgeons were identified. Robotic spine surgeons were predominantly affiliated with nonteaching hospitals (50.55%), followed by minor teaching (38.46%) and major teaching (10.99%) hospitals. Access hotspots are in the Northeast and Southeast, with rural areas showing 22% lower odds of being hotspots (OR = 0.78, <i>P</i> < .001). Factors increasing the odds of being a hotspot include higher disability prevalence (OR = 1.19, <i>P</i> < .001), lack of insurance (OR = 1.18, <i>P</i> < .001), and older median age (OR = 1.17, <i>P</i> < .001). Educational attainment and ADI, despite being significant, had lower predictive values for access.ConclusionsDisparities in access to robotic spine surgery are associated with socioeconomic, demographic, and geographic factors. The concentration of surgeons in nonteaching hospitals and higher-income areas may reflect market dynamics. Efforts to improve access should consider regional resources, hospital type, and community disadvantage.</p>","PeriodicalId":12680,"journal":{"name":"Global Spine Journal","volume":" ","pages":"21925682251356218"},"PeriodicalIF":3.0000,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187716/pdf/","citationCount":"0","resultStr":"{\"title\":\"Geographic and Socioeconomic Disparities in Robotic Spine Surgery Access in the Continental United States: A Cross-Sectional Ecological Analysis.\",\"authors\":\"Paul G Mastrokostas, Leonidas E Mastrokostas, Ahmed K Emara, Jonathan Dalton, Rajkishen Narayanan, Christopher K Kepler, Alan S Hilibrand, Alexander R Vaccaro, Jad Bou Monsef, Afshin E Razi, Mitchell K Ng\",\"doi\":\"10.1177/21925682251356218\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Study DesignCross-sectional ecological analysis.ObjectivesThis study aims to assess the availability of robotic spine surgery across the United States and identify disparities in access.MethodsWe utilized provider-finding functions from major medical equipment manufacturers to identify robotic spine surgeons and categorized affiliated hospitals. Geospatial analyses combined with socioeconomic indicators, Rural-Urban Continuum Codes, and the Area Deprivation Index (ADI) provided insights into access disparities. Multivariate logistic regression and Student's t-tests were used to identify county-level variables associated with hotspots and coldspots. Statistical significance was set at the <i>P</i> < .05 level.ResultsNinety-one robotic spine surgeons were identified. Robotic spine surgeons were predominantly affiliated with nonteaching hospitals (50.55%), followed by minor teaching (38.46%) and major teaching (10.99%) hospitals. Access hotspots are in the Northeast and Southeast, with rural areas showing 22% lower odds of being hotspots (OR = 0.78, <i>P</i> < .001). Factors increasing the odds of being a hotspot include higher disability prevalence (OR = 1.19, <i>P</i> < .001), lack of insurance (OR = 1.18, <i>P</i> < .001), and older median age (OR = 1.17, <i>P</i> < .001). Educational attainment and ADI, despite being significant, had lower predictive values for access.ConclusionsDisparities in access to robotic spine surgery are associated with socioeconomic, demographic, and geographic factors. The concentration of surgeons in nonteaching hospitals and higher-income areas may reflect market dynamics. Efforts to improve access should consider regional resources, hospital type, and community disadvantage.</p>\",\"PeriodicalId\":12680,\"journal\":{\"name\":\"Global Spine Journal\",\"volume\":\" \",\"pages\":\"21925682251356218\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-06-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187716/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Global Spine Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/21925682251356218\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Global Spine Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/21925682251356218","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
研究设计:横断面生态分析。本研究旨在评估机器人脊柱手术在美国的可用性,并确定其可及性的差异。方法利用主要医疗设备制造商的供应商查找功能,识别机器人脊柱外科医生和分类附属医院。地理空间分析结合了社会经济指标、城乡连续代码和区域剥夺指数(ADI),提供了对获取差异的见解。采用多元逻辑回归和学生t检验来识别与热点和冷点相关的县级变量。差异有统计学意义,P < 0.05。结果共鉴定出91名机器人脊柱外科医生。机器人脊柱外科医生主要隶属于非教学医院(50.55%),其次是次要教学医院(38.46%)和主要教学医院(10.99%)。接入热点在东北部和东南部,农村地区成为热点的几率低22% (OR = 0.78, P < .001)。增加成为热点的几率的因素包括较高的残疾患病率(OR = 1.19, P < .001)、缺乏保险(OR = 1.18, P < .001)和年龄中位数较大(OR = 1.17, P < .001)。受教育程度和ADI虽然很重要,但对获取的预测价值较低。结论机器人脊柱手术的可及性差异与社会经济、人口和地理因素有关。外科医生集中在非教学医院和高收入地区可能反映了市场动态。改善可及性的努力应考虑到区域资源、医院类型和社区劣势。
Geographic and Socioeconomic Disparities in Robotic Spine Surgery Access in the Continental United States: A Cross-Sectional Ecological Analysis.
Study DesignCross-sectional ecological analysis.ObjectivesThis study aims to assess the availability of robotic spine surgery across the United States and identify disparities in access.MethodsWe utilized provider-finding functions from major medical equipment manufacturers to identify robotic spine surgeons and categorized affiliated hospitals. Geospatial analyses combined with socioeconomic indicators, Rural-Urban Continuum Codes, and the Area Deprivation Index (ADI) provided insights into access disparities. Multivariate logistic regression and Student's t-tests were used to identify county-level variables associated with hotspots and coldspots. Statistical significance was set at the P < .05 level.ResultsNinety-one robotic spine surgeons were identified. Robotic spine surgeons were predominantly affiliated with nonteaching hospitals (50.55%), followed by minor teaching (38.46%) and major teaching (10.99%) hospitals. Access hotspots are in the Northeast and Southeast, with rural areas showing 22% lower odds of being hotspots (OR = 0.78, P < .001). Factors increasing the odds of being a hotspot include higher disability prevalence (OR = 1.19, P < .001), lack of insurance (OR = 1.18, P < .001), and older median age (OR = 1.17, P < .001). Educational attainment and ADI, despite being significant, had lower predictive values for access.ConclusionsDisparities in access to robotic spine surgery are associated with socioeconomic, demographic, and geographic factors. The concentration of surgeons in nonteaching hospitals and higher-income areas may reflect market dynamics. Efforts to improve access should consider regional resources, hospital type, and community disadvantage.
期刊介绍:
Global Spine Journal (GSJ) is the official scientific publication of AOSpine. A peer-reviewed, open access journal, devoted to the study and treatment of spinal disorders, including diagnosis, operative and non-operative treatment options, surgical techniques, and emerging research and clinical developments.GSJ is indexed in PubMedCentral, SCOPUS, and Emerging Sources Citation Index (ESCI).