全球到达心脏外科中心:分布,差异和目标
Dominique Vervoort1,2, Maryam Salma Babar3, Marlena E Sabatino4
1Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St, Toronto, ON, ON M5T 3M6, Canada. vervoortdominique@hotmail.com.
World journal of surgery
|August 3, 2023
概括
全球心脏手术中心的分布仍然不足,特别是在低收入国家,尽管心血管疾病负担不断增加. 目前的产能对较贫穷的地区产生了不成比例的影响,这突显了迫切需要公平获得外科护理的迫切需要.
科学领域:
- 全球健康 全球健康
- 心血管外科心血管外科
- 卫生系统研究 卫生系统研究
背景情况:
- 现有的关于心脏手术中心的全球数据已经过时,并且基于调查.
- 在中心可用性方面存在显著差异,北美每12万人口有一个中心,而撒哈拉以南非洲在1995年每3300万人口有一个中心.
- 心血管疾病 (CVD) 的负担在全球范围内不断增加.
研究的目的:
- 分析全球心脏手术中心的当代分布.
- 提出与国家心血管疾病 (CVD) 负担相对应的中心目标数量.
- 评估当前全球心脏手术能力的充分性.
主要方法:
- 识别了心脏手术中心,使用医学数据库,2010年后的数据,灰色文献和政府报告.
- 利用2019年全球疾病负担结果工具确定国家心血管疾病负担.
- 基于高收入国家的外科心血管疾病患者平均值计算中心目标,假设三分之一的心血管疾病负担是外科手术.
主要成果:
- 在230个国家确定了5111个心脏手术中心,平均为每百万人口0.73个中心.
- 低收入国家每百万人口中位数为0个中心,而高收入国家是0.75.
- 提出的目标是每百万外科心血管疾病发病率612.2 (乐观) 或306.1 (保守) 的中心;目前的低收入和中等收入国家拥有显著少.
结论:
- 心脏手术中心的容量并没有跟上日益增长的心血管疾病负担.
- 全球的外科手术能力不足,分布不公平,最受影响的是最贫穷的地区.
- 迫切需要采取行动,以解决贫困地区心脏外科服务的缺口.
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