Social Science Paradigm Challenge

You’re actually more likely to get life-saving preventative surgery at a "poor" local hospital than at a fancy university medical center.

SSRN · March 13, 2026 · 6342391

Rebecca Mae Waggoner, Charité Ricker, Qi Nie, Xiaoyue Mona Guo, Jacob G. Comeaux, Emmeline Y. Chang, Natalia Gutierrez, Daisy Hernandez, Averi Nguyen, Ivan Garcia, Fumito Ito, Laurie L. Brunette, anon Roman, Darcy Spicer, Julie O. Culver

Why it matters

It is widely assumed that prestigious, well-funded hospitals offer better uptake of advanced preventative care. This study found that high-risk patients at safety-net hospitals chose preventative surgery more often and faster than those at elite centers, even when controlling for patient age and health history.

From the abstract

ObjectiveTo explore uptake of risk-reducing gynecologic surgery in a diverse patient population with Lynch syndrome.MethodsChart reviews of women with Lynch syndrome were conducted at a safety-net hospital and university medical center, including women over age 30 with an intact uterus and/or ovaries and no prior history of uterine or ovarian cancer. Potential factors associated with uptake of surgery and time to risk-reducing surgery were analyzed.ResultsThe 65 women studied included 27 (41.5%)