Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Global surgery, obstetric, and anaesthesia indicator definitions and reporting : An Utstein consensus report

Davies, Justine I. ; Gelb, Adrian W. ; Gore-Booth, Julian ; Mellin- Olsen, Jannicke ; Martin, Janet ; Åkerman, Christina ; Ameh, Emmanuel A. ; Biccard, Bruce M. ; Braut, Geir Sverre and Chu, Kathryn M. , et al. (2021) In PLoS Medicine 18(8).
Abstract

Background: E surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define-for the first time-the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally. Methods and findings The Utstein process... (More)

Background: E surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define-for the first time-the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally. Methods and findings The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a 2-day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. The meeting was held between June 16 to 18, 2019; discussions continued until August 2020. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high-, middle-, and low-income countries. Considering each of the 6 indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2 to 5 (intermediate) and >5 year (full) time frames. We removed one of the original 6 indicators (one of 2 financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: Geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. A strength of the process was the number of people from global institutes and multilateral agencies involved in the collection and reporting of global health metrics; a limitation was the limited number of participants from low- or middle-income countries-who only made up 21% of the total attendees. Conclusions To track global progress towards timely access to quality SAO care, these indicators-at the basic level-should be implemented universally as soon as possible. Intermediate and full indicator sets should be achieved by all countries over time. Meanwhile, these evolutions can assist in the short term in developing national surgical plans and collecting more detailed data for research studies.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS Medicine
volume
18
issue
8
article number
e1003749
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:34415914
  • scopus:85113766661
ISSN
1549-1277
DOI
10.1371/journal.pmed.1003749
language
English
LU publication?
yes
id
a6c8b69a-34e9-4c0b-9a39-6cbe72675847
date added to LUP
2021-09-20 15:40:55
date last changed
2025-04-08 01:10:52
@article{a6c8b69a-34e9-4c0b-9a39-6cbe72675847,
  abstract     = {{<p>Background: E surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define-for the first time-the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally. Methods and findings The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a 2-day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. The meeting was held between June 16 to 18, 2019; discussions continued until August 2020. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high-, middle-, and low-income countries. Considering each of the 6 indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2 to 5 (intermediate) and &gt;5 year (full) time frames. We removed one of the original 6 indicators (one of 2 financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: Geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. A strength of the process was the number of people from global institutes and multilateral agencies involved in the collection and reporting of global health metrics; a limitation was the limited number of participants from low- or middle-income countries-who only made up 21% of the total attendees. Conclusions To track global progress towards timely access to quality SAO care, these indicators-at the basic level-should be implemented universally as soon as possible. Intermediate and full indicator sets should be achieved by all countries over time. Meanwhile, these evolutions can assist in the short term in developing national surgical plans and collecting more detailed data for research studies. </p>}},
  author       = {{Davies, Justine I. and Gelb, Adrian W. and Gore-Booth, Julian and Mellin- Olsen, Jannicke and Martin, Janet and Åkerman, Christina and Ameh, Emmanuel A. and Biccard, Bruce M. and Braut, Geir Sverre and Chu, Kathryn M. and Derbew, Miliard and Ersdal, Hege Langli and Guzman, Jose Miguel and Hagander, Lars and Haylock- Loor, Carolina and Holmer, Hampus and Johnson, Walter and Juran, Sabrina and Kassebaum, Nicolas J. and Laerdal, Tore and Leather, Andrew J.M. and Lipnick, Michael S. and Ljungman, Dav and Makasa, Emmanuel Malabo Mwenda and Meara, John G. and Newton, Mark W. and Østergaard, Doris and Reynolds, Teri and Romanzi, Lauri J. and Santhirapala, Vatshalan and Shrime, Mark G. and Søreide, Kjetil and Steinholt, Margit and Suzuki, Emi and Varallo, John E. and Visser, Gerard H.A. and Watters, Dav and Weiser, Thomas G.}},
  issn         = {{1549-1277}},
  language     = {{eng}},
  number       = {{8}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS Medicine}},
  title        = {{Global surgery, obstetric, and anaesthesia indicator definitions and reporting : An Utstein consensus report}},
  url          = {{http://dx.doi.org/10.1371/journal.pmed.1003749}},
  doi          = {{10.1371/journal.pmed.1003749}},
  volume       = {{18}},
  year         = {{2021}},
}