Geographic Distribution of Adult Inpatient Surgery Capability in the USA

  • Adrian Diaz
  • Anna Schoenbrunner
  • Jordan Cloyd
  • Timothy M. PawlikEmail author
Original Article



Access to timely, quality, and affordable surgical services is an important component of health care systems. A better understanding of the geographic distribution of surgical services in the USA may help identify disparities in access to surgery.


Using the 2015 American Hospital Association Annual Survey, the 2010 Census Bureau Data, and the American Community Survey 5-year estimates from 2011 to 2016, all hospitals with surgical capabilities were geocoded with 30 straight-line mile service areas around each hospital using geospatial analysis. Major surgical hospitals were defined as meeting three of the four following criteria: bed size ≥ 45, ≥ 8600 operations per year, ≥ 12 operating rooms, and academic medical center. The distribution of the US population based on proximity to a hospital capable of performing adult inpatient surgery and a major surgical hospital was then analyzed and compared.


Overall, 3409 hospitals were identified that had the capacity to perform adult inpatient surgery of which 1373 were defined as major surgical hospitals. Based on geospatial analysis, 10% of the US population was found to reside outside of a linear 30-mile radius of a surgical hospital. Younger age (OR 0.97, CI 0.96–0.97), female sex (OR 4.6, CI 4.3–5), African-American race (OR = 5.4, CI 4.7–6.2), Hispanic/Latino race (OR 5.5, CI 4.8–6.3), having completed high school or greater (OR = 3.6, CI 3–4.2), being employed (OR 4.8, CI 4.6–4.9), and having any type of health insurance were significantly associated with living in a service area.


A significant proportion of the US population lives greater than 30 straight-line miles from a major surgical hospital. Common demographic and socioeconomic factors highlight disparities in access to surgical care.


Access Geospatial Surgery Location USA 


Supplementary material

11605_2018_4078_MOESM1_ESM.docx (21 kb)
ESM 1 (DOCX 21 kb)


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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  1. 1.Division of Surgical OncologyThe Ohio State University Wexner Medical Center and James Comprehensive Cancer CenterColumbusUSA
  2. 2.Department of Plastic SurgeryThe Ohio State UniversityColumbusUSA
  3. 3.Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer ResearchThe Ohio State University, Wexner Medical CenterColumbusUSA

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