有多少手术足够? 将手术分娩与表现最好的卫生系统相结合
Mark G Shrime1, Kimberly M Daniels2, John G Meara3
1Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA; Department of Otology and Laryngology, Harvard Medical School, Boston, MA, USA; Office of Global Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA; Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
如果与表现最好的国家保持一致,全球外科手术可能会翻倍,到2030年每年从3.18亿手术增加到10亿. 这项研究为改善全球手术接入和结果提供了基准.
科学领域:
- 全球健康
- 手术结果
- 卫生系统研究
背景情况:
- 手术分娩的发生率在全世界有很大差异,与健康结果没有明显的相关性.
- 由于这种可变性,确定手术扩大规模的目标具有挑战性.
研究的目的:
- 通过分析具有最佳健康结果的国家来确定最佳的全球手术输送量.
- 提供基于证据的全球外科扩展目标.
主要方法:
- 分析了55个国家的手术分娩数据,
- 与预期寿命,产妇死亡率和5岁以下儿童死亡率相关.
- 使用回归分析来确定最佳的手术交付点,并推断到全球人口.
主要成果:
- 四个国家 (瑞典,德国,新加坡,加拿大) 代表了最佳的卫生系统表现.
- 全球目前的外科手术:每年3.18亿.
- 如果与表现最好的国家保持一致,预计每年将增加到6.3亿至8.7亿例,到2030年将达到7.5亿至10亿例.
- 高性能系统在医疗保健上花费约10%的资金,每10万人提供9000-12000次手术.
结论:
- 这项研究为医疗系统提供了第一个理想的外科输出实证数据.
- 这些发现为全球手术扩展提供了可量化的目标.
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