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An estimation of the global volume of surgery: a modelling strategy based on available data.

Publication ,  Journal Article
Weiser, TG; Regenbogen, SE; Thompson, KD; Haynes, AB; Lipsitz, SR; Berry, WR; Gawande, AA
Published in: Lancet (London, England)
July 2008

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.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.We obtained surgical data for 56 (29%) of 192 WHO member states. We estimated that 234.2 (95% CI 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 11 110 (SE 1300; p<0.0001). Middle-expenditure ($401-1000) and high-expenditure (>$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 (InterpretationWorldwide volume of surgery is large. In view of the high death and complication rates of major surgical procedures, surgical safety should now be a substantial global public-health concern. The disproportionate scarcity of surgical access in low-income settings suggests a large unaddressed disease burden worldwide. Public-health efforts and surveillance in surgery should be established.

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Published In

Lancet (London, England)

DOI

EISSN

1474-547X

ISSN

0140-6736

Publication Date

July 2008

Volume

372

Issue

9633

Start / End Page

139 / 144

Related Subject Headings

  • World Health Organization
  • Surgical Procedures, Operative
  • Population Surveillance
  • Middle Aged
  • Male
  • Linear Models
  • Life Expectancy
  • Humans
  • General & Internal Medicine
  • Female
 

Citation

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ICMJE
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Weiser, T. G., Regenbogen, S. E., Thompson, K. D., Haynes, A. B., Lipsitz, S. R., Berry, W. R., & Gawande, A. A. (2008). An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet (London, England), 372(9633), 139–144. https://doi.org/10.1016/s0140-6736(08)60878-8
Weiser, Thomas G., Scott E. Regenbogen, Katherine D. Thompson, Alex B. Haynes, Stuart R. Lipsitz, William R. Berry, and Atul A. Gawande. “An estimation of the global volume of surgery: a modelling strategy based on available data.Lancet (London, England) 372, no. 9633 (July 2008): 139–44. https://doi.org/10.1016/s0140-6736(08)60878-8.
Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet (London, England). 2008 Jul;372(9633):139–44.
Weiser, Thomas G., et al. “An estimation of the global volume of surgery: a modelling strategy based on available data.Lancet (London, England), vol. 372, no. 9633, July 2008, pp. 139–44. Epmc, doi:10.1016/s0140-6736(08)60878-8.
Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, Gawande AA. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet (London, England). 2008 Jul;372(9633):139–144.
Journal cover image

Published In

Lancet (London, England)

DOI

EISSN

1474-547X

ISSN

0140-6736

Publication Date

July 2008

Volume

372

Issue

9633

Start / End Page

139 / 144

Related Subject Headings

  • World Health Organization
  • Surgical Procedures, Operative
  • Population Surveillance
  • Middle Aged
  • Male
  • Linear Models
  • Life Expectancy
  • Humans
  • General & Internal Medicine
  • Female