Global Unmet Needs in Cardiac Surgery.

Area of Science:

• Global Health
• Cardiovascular Surgery
• Health Disparities

Background:

• Over 6 billion people in non-industrialized countries lack adequate access to cardiac surgery.
• Rising mortality from rheumatic heart disease and lifestyle diseases necessitates better surgical access.
• Previous need estimates relied on extrapolated data, lacking true service level insights.

Purpose of the Study:

• To accurately assess the need for cardiac surgery, including rheumatic, lifestyle, and congenital heart diseases.
• To determine the actual levels of cardiac surgery provided across various income-level countries.
• To identify and quantify the gap between cardiac surgery needs and service delivery.

Main Methods:

• A multi-author collaboration involving 16 countries (high, middle, and low income).
• Data collection via questionnaires, national databases, and reports from national societies.
• Analysis combining need estimations with actual service provision data.

Main Results:

• Need estimates for cardiac surgery vary widely, from 200 to over 1,000 operations per million population.
• Actual cardiac surgery provision is critically low in low- and lower-middle-income countries (average 107/million).
• Significant underdelivery of cardiac surgery is evident in both low- and middle-income countries.

Conclusions:

• A substantial gap exists between the need for and provision of life-saving cardiac surgery globally.
• Underdelivery is not confined to low-income nations but is also alarmingly high in middle-income countries.
• Urgent interventions are required to improve access to cardiac surgery worldwide.