The American College of Surgeons Health Policy Research Institute

Research portfolio

Surgical workforce and health policy research projects

ACS HPRI projects examine who provides surgical care, where services are available, how utilization and outcomes vary, and what those patterns may mean for access and policy.

Research at a glance

Six foundational questions

The project summaries below preserve the institute’s original research agenda while presenting its purpose, method, and practical value more clearly. Historical projects remain dated research records; they should not be interpreted as current workforce estimates without newer data.

Supply

Surgical workforce projections

Question: How might the surgical workforce change by specialty, gender, race, location, and relative to other medical specialties?

The project analyzes historical workforce trends and develops projection methods using sources such as the American Medical Association and American Board of Medical Specialties. Its central policy value is to make assumptions about future supply explicit rather than treating one forecast as certain.

Geography

Index of surgical underservice

Question: How can geographic availability of surgical services be compared with estimated population need?

The work examines county characteristics, population, and health care infrastructure to model surgical need and assess supply relative to that estimate. An index is a research framework, not a diagnosis of any individual community.

Variation

Trends in utilization of surgical services

Question: How did high-volume procedure use vary over time and across geography?

The study focuses on orthopedic, cardiovascular, and oncology procedures in North Carolina and the United States between 1997 and 2008. It considers technology, practice patterns, payment policy, patient characteristics, providers, and local population context.

Outcomes

Surgery-sensitive conditions and hospital access

Question: Is local access to general surgical expertise associated with outcomes for selected urgent conditions?

The project uses inpatient discharge data to study length of stay, illness stage, and complications for selected surgery-sensitive and reference conditions. Association in observational data requires cautious interpretation.

Rural access

Sustainability of rural surgery

Question: What helps or hinders physicians and hospitals in maintaining rural surgical services?

A web-based survey of rural surgeons and hospital administrators examines scope of care, operational pressures, workforce decisions, and challenges specific to rural surgery programs.

Interactive data

Surgery Workforce Atlas

Question: How can geographic workforce patterns be made understandable and explorable?

The Atlas presents state-level workforce data in a searchable map and table. The current interface explicitly identifies the available fields and limitations rather than inferring units, dates, or county detail that the source file does not contain.

Open the interactive Atlas →

How to use the research

Read the method before the headline

Workforce and access studies often combine administrative records, population estimates, geographic definitions, and statistical models. A useful reading asks what was measured, when it was measured, which population was included, and whether the result describes association, projection, or observed change.

Research checklist

  • Confirm the data years and geographic unit.
  • Read definitions for specialties and active practice.
  • Separate observed findings from projections.
  • Review limitations before applying results today.
Related evidence

Continue through the research library

Maps

Interactive data plus downloadable specialty collections.

Map library →

Project questions

Frequently asked questions

Are these projects active today?

This page preserves foundational ACS HPRI research projects. Some describe historical study periods or completed work. Use the publication date, data year, and linked Newsroom coverage to distinguish archival evidence from newer reporting.

What is surgical underservice?

Surgical underservice is a research concept used to compare estimated population need with the availability of surgical resources. The result depends on definitions, data sources, geography, and model assumptions; it should not be treated as a fixed label without reviewing the method.

Where are the results?

Use the Publications page for fact sheets and reports, Maps for geographic products, and the interactive Atlas for the current public dataset interface. Project descriptions explain the research question but do not replace the underlying report.

Need a source for a project?

Start with the publication library, then contact the institute with the project title and intended use.

Contact ACS HPRI

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