全球手术和麻醉任务转移:一个系统的文献审查和调查
Frederik Federspiel1, Swagoto Mukhopadhyay2, Penelope Milsom3
1Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA.
Lancet (London, England)
|August 28, 2015
概括
转移任务,将手术任务转移给临床医生, 在全球范围内是解决劳动力短缺的问题. 虽然监管很广泛,但在低收入国家尤其存在很大差异,这凸显了对结果的研究的需要.
科学领域:
- 全球健康
- 外科人员发展
- 医疗保健政策
背景情况:
- 由于全球手术人员短缺,
- 这是扩大外科能力的一种策略.
- 了解全球任务转移对于战略规划至关重要.
研究的目的:
- 记录全球使用的手术和麻醉任务转移.
- 分析不同地区和收入群体的任务转移实践.
- 为弥补手术和麻醉提供者的缺口提供信息.
主要方法:
- 在多个数据库中进行了PRISMA指导的文献搜索 (1995-2014).
- 从62个研究中提取了关于干部,任务,培训和监督的数据.
- 通过向19个国家的外科医生和麻醉师发送的未经验证的调查证实了这种做法.
主要成果:
- 在174个国家记录了任务转移,麻醉任务转移比手术更为普遍 (65%).
- 在世界银行的所有收入群体中都观察到这种做法.
- 在高收入国家对临床助理的监督是常见的,但在低收入国家对手术和麻醉手术都不存在.
结论:
- 任务转移是增加全球所有地区和收入水平的外科工作人员的重要策略.
- 副临床医生是外科工作人员的重要组成部分, 应纳入扩展计划.
- 需要进一步的研究来评估结果,特别是在监管不那么严格的低收入和中等收入国家.
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