Evaluating the collection, comparability and findings of six global surgery indicators.
Journal
The British journal of surgery
ISSN: 1365-2168
Titre abrégé: Br J Surg
Pays: England
ID NLM: 0372553
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
29
07
2018
revised:
01
10
2018
accepted:
30
10
2018
pubmed:
21
12
2018
medline:
7
5
2019
entrez:
21
12
2018
Statut:
ppublish
Résumé
In 2015, six indicators were proposed to evaluate global progress towards access to safe, affordable and timely surgical and anaesthesia care. Although some have been adopted as core global health indicators, none has been evaluated systematically. The aims of this study were to assess the availability, comparability and utility of the indicators, and to present available data and updated estimates. Nationally representative data were compiled for all World Health Organization (WHO) member states from 2010 to 2016 through contacts with official bodies and review of the published and grey literature, and available databases. Availability, comparability and utility were assessed for each indicator: access to timely essential surgery, specialist surgical workforce density, surgical volume, perioperative mortality, and protection against impoverishing and catastrophic expenditure. Where feasible, imputation models were developed to generate global estimates. Of all WHO member states, 19 had data on the proportion of the population within 2h of a surgical facility, 154 had data on workforce density, 72 reported number of procedures, and nine had perioperative mortality data, but none could report data on catastrophic or impoverishing expenditure. Comparability and utility were variable, and largely dependent on different definitions used. There were sufficient data to estimate that worldwide, in 2015, there were 2 038 947 (i.q.r. 1 884 916-2 281 776) surgeons, obstetricians and anaesthetists, and 266·1 (95 per cent c.i. 220·1 to 344·4) million operations performed. Surgical and anaesthesia indicators are increasingly being adopted by the global health community, but data availability remains low. Comparability and utility for all indicators require further resolution.
Sections du résumé
BACKGROUND
In 2015, six indicators were proposed to evaluate global progress towards access to safe, affordable and timely surgical and anaesthesia care. Although some have been adopted as core global health indicators, none has been evaluated systematically. The aims of this study were to assess the availability, comparability and utility of the indicators, and to present available data and updated estimates.
METHODS
Nationally representative data were compiled for all World Health Organization (WHO) member states from 2010 to 2016 through contacts with official bodies and review of the published and grey literature, and available databases. Availability, comparability and utility were assessed for each indicator: access to timely essential surgery, specialist surgical workforce density, surgical volume, perioperative mortality, and protection against impoverishing and catastrophic expenditure. Where feasible, imputation models were developed to generate global estimates.
RESULTS
Of all WHO member states, 19 had data on the proportion of the population within 2h of a surgical facility, 154 had data on workforce density, 72 reported number of procedures, and nine had perioperative mortality data, but none could report data on catastrophic or impoverishing expenditure. Comparability and utility were variable, and largely dependent on different definitions used. There were sufficient data to estimate that worldwide, in 2015, there were 2 038 947 (i.q.r. 1 884 916-2 281 776) surgeons, obstetricians and anaesthetists, and 266·1 (95 per cent c.i. 220·1 to 344·4) million operations performed.
CONCLUSION
Surgical and anaesthesia indicators are increasingly being adopted by the global health community, but data availability remains low. Comparability and utility for all indicators require further resolution.
Identifiants
pubmed: 30570764
doi: 10.1002/bjs.11061
pmc: PMC6790969
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e138-e150Informations de copyright
© 2018 The Authors. BJS published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.
Références
Lancet. 2009 Sep 26;374(9695):1113-7
pubmed: 19782877
PLoS Med. 2009 May 19;6(5):e1000078
pubmed: 19440533
JAMA Surg. 2016 Nov 1;151(11):1064-1069
pubmed: 27580500
BMJ Glob Health. 2018 Aug 16;3(4):e000875
pubmed: 30147944
World J Surg. 2015 Sep;39(9):2115-25
pubmed: 26239773
Lancet Glob Health. 2015 Aug;3(8):e487-e495
pubmed: 26187491
Lancet Glob Health. 2015 Apr 27;3 Suppl 2:S13-20
pubmed: 25926315
Lancet Glob Health. 2018 Feb;6(2):e152-e168
pubmed: 29248365
Lancet. 2014 Jan 4;383(9911):12-13
pubmed: 24332309
Lancet. 2018 Apr 21;391(10130):1589-1598
pubmed: 29306587
World J Surg. 2014 Jun;38(6):1398-404
pubmed: 24407941
PLoS One. 2017 Oct 31;12(10):e0187293
pubmed: 29088302
Lancet. 2018 Mar 10;391(10124):920-921
pubmed: 29501235
BMJ. 2011 May 13;342:d2600
pubmed: 21571914
World J Surg. 2016 Aug;40(8):1865-73
pubmed: 27142621
BMJ Glob Health. 2017 May 18;2(2):e000226
pubmed: 28589025
Glob Health Sci Pract. 2017 Sep 28;5(3):430-445
pubmed: 28839113
BMJ Glob Health. 2017 Nov 25;2(4):e000376
pubmed: 29225948
Br J Surg. 2016 Jul;103(8):971-988
pubmed: 27145169
Lancet Glob Health. 2018 Mar;6(3):e342-e350
pubmed: 29396220
World J Surg. 2017 May;41(5):1218-1224
pubmed: 27905017
Lancet. 2018 May 12;391(10133):1927-1938
pubmed: 29550029
Hum Resour Health. 2007 Jun 14;5:17
pubmed: 17570847
Bull Am Coll Surg. ;102(4):11-6
pubmed: 28920641
Lancet. 2013 Sep 28;382(9898):1140-51
pubmed: 24075054
Br J Surg. 2016 Oct;103(11):1453-61
pubmed: 27428044
Bull World Health Organ. 2016 Mar 1;94(3):201-209F
pubmed: 26966331
Lancet. 2008 Jul 12;372(9633):139-44
pubmed: 18582931
Surgery. 2015 Jun;157(6):992-1001
pubmed: 25934081
Lancet Glob Health. 2015 Apr 27;3 Suppl 2:S9-11
pubmed: 25926323
Lancet. 2015 Aug 8;386(9993):569-624
pubmed: 25924834
Lancet Glob Health. 2015 Apr 27;3 Suppl 2:S38-44
pubmed: 25926319
Lancet. 2007 Dec 22;370(9605):2158-63
pubmed: 17574662
Health Aff (Millwood). 2016 Mar;35(3):415-21
pubmed: 26953295
Anesth Analg. 2017 Sep;125(3):981-990
pubmed: 28753173
Lancet Infect Dis. 2018 May;18(5):516-525
pubmed: 29452941
Int J Surg. 2015 Jan;13:211-216
pubmed: 25498494
Br J Surg. 2017 Sep;104(10):1315-1326
pubmed: 28783227
World J Surg. 2014 Aug;38(8):1954-60
pubmed: 24615608