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Changes in the general surgical workload, 1991-1999.
1Department of Surgery, Newport Hospital, 96 Washington Street, Newport, RI 02840, USA. drcpshoe@ids.net
Archives of Surgery (Chicago, Ill. : 1960)
|April 11, 2003
Summary
General surgeons performed fewer major procedures from 1991-1999, with declines in breast, colon, and hernia surgeries. However, minor procedure volumes, including vascular and endoscopic surgery, saw slight increases.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Vascular Surgery
Background:
- The scope of general surgery has evolved, with shifts in procedure volumes and types performed by general surgeons.
- Understanding these trends is crucial for surgical training, resource allocation, and healthcare policy.
Purpose of the Study:
- To analyze changes in the volume and types of general surgical procedures performed between 1991 and 1999.
- To identify trends in both major and minor surgical procedures undertaken by general surgeons.
Main Methods:
- Utilized Medicare data from 1991-1999.
- Defined "general surgical" procedures as those with >1000 annual cases performed by general surgeons.
- Categorized procedures into major and minor, analyzing volumes performed by all surgeons versus general surgeons.
Main Results:
- Overall major general surgical procedures decreased by 1.8% (8846 cases) despite a 17,544 case increase by all surgeons.
- Volumes increased for appendectomy and cholecystectomy, but decreased for breast surgery, hernia repair, splenectomy, and colon resection.
- Minor general surgical procedures saw a slight increase, with gains in vascular and endoscopic surgery.
Conclusions:
- General surgeons experienced a net decrease in major procedure volume from 1991-1999.
- This decline is attributed to reduced involvement in subspecialty areas and decreased performance of specific procedures like colon surgery and hernia repairs.
- Despite overall declines in major procedures, specific operations like appendectomies and cholecystectomies increased, alongside a rise in minor procedures.