Projections to achieve minimum surgical rate threshold: an observational study

Area of Science:

• Global Health
• Surgical Services Research
• Health Systems Strengthening

Background:

• Surgical services are expanding globally, especially in resource-limited settings, yet growth rates are insufficient to meet public health demands.
• The Lancet Commission on Global Surgery recommends a minimum of 5000 operations per 100,000 population for desirable health outcomes.
• Understanding the trajectory of surgical rate growth is crucial for addressing global surgical needs.

Purpose of the Study:

• To evaluate the rates of growth in surgical procedures across different global regions between 2004 and 2012.
• To estimate the time required for various regions to achieve the recommended minimum surgical rate threshold of 5000 operations per 100,000 population.

Main Methods:

• Utilized country-level surgical rate data from 2004 and 2012, aggregated into 21 Global Burden of Disease (GBD) regions.
• Calculated mean surgical rates per capita and analyzed the rate of growth between the two data points.
• Employed linear extrapolation to project the time needed to reach the 5000 operations per 100,000 population benchmark.

Main Results:

• Most regions (except Central Europe and Southern Latin America) showed increased surgical rates, with the fastest growth in regions having the lowest initial rates.
• In 2012, 14 regions (79% of the global population) had not met the recommended surgical rate threshold.
• At current growth rates, seven regions will not reach the threshold by 2035, with Eastern Sub-Saharan Africa projected to reach it in 2124.

Conclusions:

• Surgical service delivery growth rates vary significantly, with the highest rates observed in the poorest regions.
• Current growth trajectories indicate that 70% of the world's population will still lack adequate surgical rates by 2035.
• A concerted strategy to enhance surgical capacity is imperative for achieving global surgical targets within integrated health systems.