Unveiling Equitable Surgical Prioritization: Insights From a Comprehensive Analysis Using the Medically Necessary and Time-Sensitive (MeNTS) Scoring System

Background: This study addresses the intricate landscape of racial disparities in healthcare delivery, with a specific focus on surgical procedures. The concern was accentuated by the challenges posed during the COVID-19 pandemic when resources became scarce. Recognizing the potential impact of provider bias in medical decision-making, the American College of Surgeons introduced the Medically Necessary and Time-Sensitive (MeNTS) scoring system. This methodology aims to address procedures that, while not emergent, are deemed medically necessary and time-sensitive. This study analyzed whether using this scoring system decreased racial disparities between patients receiving surgery during the pandemic.

Methodology: A retrospective cross-sectional study was conducted using Electronic Medical Records from June 1, 2020, to December 31, 2021. We analyzed variations in MeNTS scores and time to surgery based on racial and ethnic backgrounds using bivariate and multivariate analyses.

Results: The analysis included 2,997 patients. Of these, 1,442 (42.84%) were Hispanic participants, 1,282 (38.09%) were non-Hispanic participants, and 642 (19.07%) were participants of other specified ethnic backgrounds. The racial composition comprised 2,955 (87.79%) White participants, 98 (2.91%) Asian participants, 50 (1.49%) African American participants, and 72 (2.14%) Alaska Native or American Indian participants. No significant differences in mean days to surgery or MeNTS scores were observed across racial and ethnic groups (Hispanic participants = 76.62 vs. non-Hispanic participants = 78.82, P = 0.8). A multivariate survival model showed that MeNTS scores below 30 were associated with higher surgery likelihood, with no significant disparities in race, ethnicity, or gender.

Conclusions: This comprehensive study utilizing the MeNTS scoring system reveals an absence of statistically significant racial disparities in surgical prioritization. These findings contribute valuable insights to the ongoing discourse surrounding equitable healthcare practices and emphasize the potential efficacy of standardized scoring systems in mitigating biases in medical decision-making.