Intermittent and mobile surgical services: logistics and outcomes

Area of Science:

• Global Health
• Surgical Care Delivery
• Healthcare Systems

Background:

• Many regions lack consistent access to surgical services.
• Mobile facilities can bridge gaps in healthcare access.
• Ecuador faced challenges in providing surgical care to remote areas.

Purpose of the Study:

• To analyze the fiscal and clinical outcomes of an intermittent mobile surgical services program.
• To evaluate the program's integration with primary care sites in Ecuador.
• To assess the sustainability and cost-effectiveness of mobile surgical interventions.

Main Methods:

• A mobile surgical unit supported primary care sites across 15 provinces in Ecuador from 1994-2003.
• Standardized criteria for patient inclusion, follow-up, and medical record-keeping were implemented.
• Clinical outcomes (complications, deaths) and financial data were collected and analyzed.

Main Results:

• A total of 4,545 general surgery operations were performed.
• The program conducted 40-50 excursions annually, proving to be a stable care element.
• There were no deaths, 4 major complications, and 3 minor complications, with a cost under $100 per operation.

Conclusions:

• Intermittent mobile surgical services, integrated with primary care, offer a sustainable, high-quality clinical program.
• The program demonstrated significant cost-effectiveness compared to international volunteer organizations.
• In-country resources can enhance healthcare services affordably and effectively.