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Low-Value Surgical Procedures in Low- and Middle-Income Countries: A Systematic Scoping Review.

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This summary is machine-generated.

Overuse of surgical procedures is rising globally, particularly in low- and middle-income countries (LMICs). Unnecessary cesarean deliveries are a major concern, leading to harm and significant costs.

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Area of Science:

  • Global Health
  • Surgical Outcomes
  • Health Economics

Background:

  • Increasing global surgical procedure rates pose risks to individuals and healthcare systems.
  • Low- and middle-income countries (LMICs) show evidence of rising overuse for specific procedures.

Purpose of the Study:

  • To assess the extent, factors, consequences, and solutions for low-value surgical procedures in LMICs.
  • To synthesize existing evidence on surgical overuse in resource-limited settings.

Main Methods:

  • Systematic review of 4 electronic databases (PubMed, Embase, PsycINFO, Global Index Medicus).
  • Inclusion of studies from database inception to April 27, 2022, with no date or language restrictions.
  • Categorization of 133 included studies (from 63 countries) by focus: extent, factors, consequences, and solutions.

Main Results:

  • Analysis of over 9.1 million surgical procedures across 133 studies.
  • Unnecessary cesarean delivery was the most reported overuse (12-81% rates in LMICs), costing China an estimated $3.29 billion annually.
  • Other procedures with limited evidence included abdominal and cardiovascular surgeries; private financing was an associated factor.

Conclusions:

  • Growing evidence confirms surgical procedure overuse in LMICs, causing harm and wasting resources.
  • Unnecessary cesarean delivery is a primary driver of this overuse.
  • Further research is needed on other surgical procedures and robust evaluation of interventions is required.