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.
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.
Authors: Thomas G Weiser; Alex B Haynes; George Molina; Stuart R Lipsitz; Micaela M Esquivel; Tarsicio Uribe-Leitz; Rui Fu; Tej Azad; Tiffany E Chao; William R Berry; Atul A Gawande Journal: Lancet Date: 2015-04-26 Impact factor: 79.321
Authors: Thomas G Weiser; Tarsicio Uribe-Leitz; Rui Fu; Joshua Jaramillo; Lydia Maurer; Micaela M Esquivel; Atul A Gawande; Alex B Haynes Journal: Lancet Date: 2015-04-26 Impact factor: 79.321
Authors: Dean T Jamison; Lawrence H Summers; George Alleyne; Kenneth J Arrow; Seth Berkley; Agnes Binagwaho; Flavia Bustreo; David Evans; Richard G A Feachem; Julio Frenk; Gargee Ghosh; Sue J Goldie; Yan Guo; Sanjeev Gupta; Richard Horton; Margaret E Kruk; Adel Mahmoud; Linah K Mohohlo; Mthuli Ncube; Ariel Pablos-Mendez; K Srinath Reddy; Helen Saxenian; Agnes Soucat; Karen H Ulltveit-Moe; Karene H Ulltveit-Moe; Gavin Yamey Journal: Lancet Date: 2013-12-03 Impact factor: 79.321
Authors: Thomas G Weiser; Scott E Regenbogen; Katherine D Thompson; Alex B Haynes; Stuart R Lipsitz; William R Berry; Atul A Gawande Journal: Lancet Date: 2008-06-24 Impact factor: 79.321
Authors: Thomas G Weiser; Martin A Makary; Alex B Haynes; Gerald Dziekan; William R Berry; Atul A Gawande Journal: Lancet Date: 2009-09-26 Impact factor: 79.321
Authors: Micaela M Esquivel; George Molina; Tarsicio Uribe-Leitz; Stuart R Lipsitz; John Rose; Stephen Bickler; Atul A Gawande; Alex B Haynes; Thomas G Weiser Journal: World J Surg Date: 2015-09 Impact factor: 3.352
Authors: Anna J Dare; Caris E Grimes; Rowan Gillies; Sarah L M Greenberg; Lars Hagander; John G Meara; Andrew J M Leather Journal: Lancet Date: 2014-05-19 Impact factor: 79.321
Authors: Yuanting Zha; Barclay Stewart; Eugenia Lee; Kyle N Remick; David H Rothstein; Reinou S Groen; Gilbert Burnham; David K Imagawa; Adam L Kushner Journal: World J Surg Date: 2016-11 Impact factor: 3.352
Authors: Joshua S Ng-Kamstra; Sarah L M Greenberg; Fizan Abdullah; Vanda Amado; Geoffrey A Anderson; Matchecane Cossa; Ainhoa Costas-Chavarri; Justine Davies; Haile T Debas; George S M Dyer; Sarnai Erdene; Paul E Farmer; Amber Gaumnitz; Lars Hagander; Adil Haider; Andrew J M Leather; Yihan Lin; Robert Marten; Jeffrey T Marvin; Craig D McClain; John G Meara; Mira Meheš; Charles Mock; Swagoto Mukhopadhyay; Sergelen Orgoi; Timothy Prestero; Raymond R Price; Nakul P Raykar; Johanna N Riesel; Robert Riviello; Stephen M Rudy; Saurabh Saluja; Richard Sullivan; John L Tarpley; Robert H Taylor; Louis-Franck Telemaque; Gabriel Toma; Asha Varghese; Melanie Walker; Gavin Yamey; Mark G Shrime Journal: BMJ Glob Health Date: 2016-04-06
Authors: Kristina E Rudd; Niranjan Kissoon; Direk Limmathurotsakul; Sotharith Bory; Birungi Mutahunga; Christopher W Seymour; Derek C Angus; T Eoin West Journal: Crit Care Date: 2018-09-23 Impact factor: 9.097