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Evaluating the collection, comparability and findings of six global surgery indicators

Holmer, H. LU ; Bekele, A.; Hagander, L. LU ; Harrison, E. M.; Kamali, P.; Ng-Kamstra, J. S.; Khan, M. A.; Knowlton, L.; Leather, A. J.M. and Marks, I. H., et al. (2019) In British Journal of Surgery 106(2). p.138-150
Abstract

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 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... (More)

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 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.

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published
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British Journal of Surgery
volume
106
issue
2
pages
138 - 150
publisher
John Wiley & Sons
external identifiers
  • scopus:85058843667
ISSN
0007-1323
DOI
10.1002/bjs.11061
language
English
LU publication?
yes
id
1297b8cd-a146-453f-8a16-88703f7aff4f
date added to LUP
2019-01-14 13:57:27
date last changed
2019-01-15 03:00:10
@article{1297b8cd-a146-453f-8a16-88703f7aff4f,
  abstract     = {<p>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 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.</p>},
  author       = {Holmer, H. and Bekele, A. and Hagander, L. and Harrison, E. M. and Kamali, P. and Ng-Kamstra, J. S. and Khan, M. A. and Knowlton, L. and Leather, A. J.M. and Marks, I. H. and Meara, J. G. and Shrime, M. G. and Smith, M. and Søreide, K. and Weiser, T. G. and Davies, J.},
  issn         = {0007-1323},
  language     = {eng},
  number       = {2},
  pages        = {138--150},
  publisher    = {John Wiley & Sons},
  series       = {British Journal of Surgery},
  title        = {Evaluating the collection, comparability and findings of six global surgery indicators},
  url          = {http://dx.doi.org/10.1002/bjs.11061},
  volume       = {106},
  year         = {2019},
}