An estimation of the global volume of surgery: a modelling strategy based on available data
An estimation of the global volume of surgery: a modelling strategy based on available data
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DOI：
10.1016/s0140-6736(08)60878-8
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发表时间：
2008-07-12
期刊：
影响因子：
168.9
通讯作者：
Gawande, Atul A.
中科院分区：
文献类型：
--
作者：
Weiser, Thomas G.;Regenbogen, Scott E.;Gawande, Atul A.
背景对全球外科治疗的数量和可获得性知之甚少。我们估计了全球大手术的数量，描述了它们的分布，并评估了外科护理在全球公共卫生政策中的重要性。方法我们收集了世界卫生组织192个成员国的人口、卫生和经济数据。从政府机构、统计和流行病学组织、已发表的研究和参与手术政策倡议的个人等几个来源寻求手术率的数据。我们还从2004年的分析中获得了人均卫生总支出。大手术被定义为发生在医院手术室中的任何干预措施，涉及组织的切开、切除、操作或缝合，通常需要局部或全身麻醉或镇静。我们创建了一个模型来估计没有这类数据的国家的大手术率，然后使用人口统计信息来计算世界范围内的手术总量。我们估计，全球每年有234.2(95%CI 187.2-281.2)百万例大型外科手术。在医疗保健方面人均花费在100美元以下的国家，估计每年每10万人中有295例(SE53)大手术，而那些花费超过1,000美元的国家的平均手术率为11110(SE1300；P$1000)，占世界人口的30.2%，在2004年提供了73.6%(1.723亿)的手术，而支出较低的国家(SE1300；p$1000)在2004年提供了73.6%(1.723亿)的手术
Background Little is known about the amount and availability of surgical care globally. We estimated the number of major operations undertaken worldwide, described their distribution, and assessed the importance of surgical care in global public-health policy.Methods We gathered demographic, health, and economic data for 192 member states of WHO. Data for the rate of surgery were sought from several sources including governmental agencies, statistical and epidemiological organisations, published studies, and individuals involved in surgical policy initiatives. We also obtained per-head total expenditure on health from analyses done in 2004. Major surgery was defined as any intervention occurring in a hospital operating theatre involving the incision, excision, manipulation, or suturing of tissue, usually requiring regional or general anaesthesia or sedation. We created a model to estimate rates of major surgery for countries for which such data were unavailable, then used demographic information to calculate the total worldwide volume of surgery.Findings We obtained surgical data for 56 (29%) of 192 WHO member states. We estimated that 234.2 (95% Cl 187.2-281.2) million major surgical procedures are undertaken every year worldwide. Countries spending US$100 or less per head on health care have an estimated mean rate of major surgery of 295 (SE 53) procedures per 100 000 population per year, whereas those spending more than $1000 have a mean rate of 11110 (SE 1300; p$1000) countries, accounting for 30.2% of the world's population, provided 73.6% (172.3 million) of operations worldwide in 2004, whereas poor-expenditure (