This article was originally published here
Plast Reconstr Surg. 2021 Feb 8. doi: 10.1097/PRS.0000000000007682. Online ahead of print.
BACKGROUND: In this systematic review, we report on the current state of health disparities research in plastic surgery and consider how equity-oriented interventions are taking shape at the patient, provider, and healthcare system levels.
METHODS: We performed a systematic literature search of the PubMed/MEDLINE and Embase databases using search terms related to both the social determinants of health and plastic surgery. Two independent reviewers screened the article titles and abstracts for relevance and identified the plastic surgery focus and study characteristics of the included literature. The articles were then categorized as detecting, understanding, or reducing health disparities according to a conceptual framework. This review was conducted in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The protocol is available on PROSPERO (ID number CRD42020150245).
RESULTS: One hundred forty-seven articles published between 1997 and 2019 met the inclusion criteria. Health disparities research in gender-affirming, craniofacial, cosmetic, and hand surgery was lacking relative to breast reconstruction. Racial/ethnic and socioeconomic disparities were reported across subspecialties. Place of residence was also a large determinant of access to care and quality of surgical outcomes. Half of the included studies were in the detecting phase of research. Meanwhile, 40 and 10 percent were in the understanding and reducing phases, respectively.
CONCLUSIONS: Investigators suggested several avenues for reducing health disparities in plastic surgery, yet there is limited evidence on the actual effectiveness of equity-oriented initiatives. More comprehensive research is needed to disentangle the patient, provider, and system-level factors that underlie inequity across subspecialties.