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Published in: World Journal of Surgery 9/2015

01-09-2015 | Original Scientific Report

Projections for Achieving the Lancet Commission Recommended Surgical Rate of 5000 Operations per 100,000 Population by Region-Specific Surgical Rate Estimates

Authors: Tarsicio Uribe-Leitz, Micaela M. Esquivel, George Molina, Stuart R. Lipsitz, Stéphane Verguet, John Rose, Stephen W. Bickler, Atul A. Gawande, Alex B. Haynes, Thomas G. Weiser

Published in: World Journal of Surgery | Issue 9/2015

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Abstract

Background

We previously identified a range of 4344–5028 annual operations per 100,000 people to be related to desirable health outcomes. From this and other evidence, the Lancet Commission on Global Surgery recommends a minimum rate of 5000 operations per 100,000 people. We evaluate rates of growth and estimate the time it will take to reach this minimum surgical rate threshold.

Methods

We aggregated country-level surgical rate estimates from 2004 to 2012 into the twenty-one Global Burden of Disease (GBD) regions. We calculated mean rates of surgery proportional to population size for each year and assessed the rate of growth over time. We then extrapolated the time it will take each region to reach a surgical rate of 5000 operations per 100,000 population based on linear rates of change.

Results

All but two regions experienced growth in their surgical rates during the past 8 years. Fourteen regions did not meet the recommended threshold in 2012. If surgical capacity continues to grow at current rates, seven regions will not meet the threshold by 2035. Eastern Sub-Saharan Africa will not reach the recommended threshold until 2124.

Conclusion

The rates of growth in surgical service delivery are exceedingly variable. At current rates of surgical and population growth, 6.2 billion people (73 % of the world’s population) will be living in countries below the minimum recommended rate of surgical care in 2035. A strategy for strengthening surgical capacity is essential if these targets are to be met in a timely fashion as part of the integrated health system development.
Literature
1.
go back to reference Dare AJ, Grimes CE, Gillies R et al (2014) Global surgery: defining an emerging global health field. The Lancet 384(9961):2245–2247CrossRef Dare AJ, Grimes CE, Gillies R et al (2014) Global surgery: defining an emerging global health field. The Lancet 384(9961):2245–2247CrossRef
2.
go back to reference Meara JG, Hagander L (2014) Leather. AJM Surgery and global health: A Lancet Commission The Lancet 383:12–13 Meara JG, Hagander L (2014) Leather. AJM Surgery and global health: A Lancet Commission The Lancet 383:12–13
3.
go back to reference Debas H, Gosselin R, McCord C et al (2006) Surgery. In: Jamison DT, Breman JG, Measham AR et al (eds) Disease control priorities in developing countries. Disease control priorities project, 2nd edn. The International Bank for Reconstruction and Development/The World Bank, Washington Debas H, Gosselin R, McCord C et al (2006) Surgery. In: Jamison DT, Breman JG, Measham AR et al (eds) Disease control priorities in developing countries. Disease control priorities project, 2nd edn. The International Bank for Reconstruction and Development/The World Bank, Washington
4.
go back to reference Beye MD, Diouf E, Kane O et al (2003) Intensive care management of 28 patients with severe eclampsia in a tropical African setting. Annales Francaises D Anesthesie Et De Reanimation 22:25–29PubMedCrossRef Beye MD, Diouf E, Kane O et al (2003) Intensive care management of 28 patients with severe eclampsia in a tropical African setting. Annales Francaises D Anesthesie Et De Reanimation 22:25–29PubMedCrossRef
5.
go back to reference Weiser TG, Makary MA, Haynes AB et al (2009) Standardised metrics for global surgical surveillance. The Lancet 374:1113–1117CrossRef Weiser TG, Makary MA, Haynes AB et al (2009) Standardised metrics for global surgical surveillance. The Lancet 374:1113–1117CrossRef
6.
go back to reference Weiser TG, Regenbogen SE, Thompson KD et al (2008) An estimation of the global volume of surgery: a modelling strategy based on available data. The Lancet 372:139–144CrossRef Weiser TG, Regenbogen SE, Thompson KD et al (2008) An estimation of the global volume of surgery: a modelling strategy based on available data. The Lancet 372:139–144CrossRef
9.
go back to reference Jamison DT, Summers LH, Alleyne G et al (2013) Global health 2035: a world converging within a generation. The Lancet 382:1898–1955CrossRef Jamison DT, Summers LH, Alleyne G et al (2013) Global health 2035: a world converging within a generation. The Lancet 382:1898–1955CrossRef
10.
go back to reference Esquivel MM, Molina G, Uribe-Leitz T et al (2015) Proposed minimum rates of surgery to support desirable health outcomes: an observational study based on three strategies. World J Surg. doi:10.1007/s00268-015-3092-7 Esquivel MM, Molina G, Uribe-Leitz T et al (2015) Proposed minimum rates of surgery to support desirable health outcomes: an observational study based on three strategies. World J Surg. doi:10.​1007/​s00268-015-3092-7
13.
go back to reference Weiser TG, Uribe-Leitz T, Fu R et al (2015) Variability in mortality following caeserean delivery, appendectomy, and groin hernia repair in low and middle income countries: implications for expanding surgical services. The Lancet. doi:10.1016/S0140-6736(15)60829-7 Weiser TG, Uribe-Leitz T, Fu R et al (2015) Variability in mortality following caeserean delivery, appendectomy, and groin hernia repair in low and middle income countries: implications for expanding surgical services. The Lancet. doi:10.​1016/​S0140-6736(15)60829-7
14.
go back to reference World Health Report 2010. (2010) Health systems financing: the path to universal coverage. World Health Organization, Geneva World Health Report 2010. (2010) Health systems financing: the path to universal coverage. World Health Organization, Geneva
Metadata
Title
Projections for Achieving the Lancet Commission Recommended Surgical Rate of 5000 Operations per 100,000 Population by Region-Specific Surgical Rate Estimates
Authors
Tarsicio Uribe-Leitz
Micaela M. Esquivel
George Molina
Stuart R. Lipsitz
Stéphane Verguet
John Rose
Stephen W. Bickler
Atul A. Gawande
Alex B. Haynes
Thomas G. Weiser
Publication date
01-09-2015
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 9/2015
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-015-3113-6

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