[EQ] Surgery unavailable to one third of the world's population

Global operating theatre distribution and pulse oximetry supply:
an estimation from reported data

Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA (L M Funk, T G Weiser, W R Berry, A A Gawande);
Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, MA, USA (L M Funk, T G Weiser, W R Berry, S R Lipsitz ScD, A A Gawande);

Department of Anaesthesiology, University of Auckland and Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand (Prof A F Merry FANZCA);

University of British Columbia, Royal Jubilee Hospital, Victoria, British Columbia, Canada (Prof A C Enright FRCPC);

Royal Devon and Exeter NHS Foundation Trust, Exeter, UK (I H Wilson FRCA); and
World Health Organization Patient Safety Programme, Geneva, Switzerland (G Dziekan )

The Lancet, 1 July 2010doi:10.1016/S0140-6736(10)60392-3

 

“………………Of an estimated 234 million surgical procedures done every year, the wealthiest third of the global population has 75% of the operations, whereas the poorest third undergoes only 4%.7…”

Abstract: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60392-3/fulltext

“…….Surgery is an essential part of health care, but resources to ensure the availability of surgical services are often inadequate. We estimated the global distribution of operating theatres and quantified the availability of pulse oximetry, which is an essential monitoring device during surgery and a potential measure of operating theatre resources.

Methods

We calculated ratios of the number of operating theatres to hospital beds in seven geographical regions worldwide on the basis of profiles from 769 hospitals in 92 countries that participated in WHO's safe surgery saves lives initiative. We used hospital bed figures from 190 WHO member states to estimate the number of operating theatres per 100 000 people in 21 subregions throughout the world. To estimate availability of pulse oximetry, we sent surveys to anaesthesia providers in 72 countries selected to ensure a geographically and demographically diverse sample. A predictive regression model was used to estimate the pulse oximetry need for countries that did not provide data.

Findings

The estimated number of operating theatres ranged from 1·0 (95% CI 0·9—1·2) per 100 000 people in west sub-Saharan Africa to 25·1 (20·9—30·1) per 100 000 in eastern Europe. High-income subregions all averaged more than 14 per 100 000 people, whereas all low-income subregions, representing 2·2 billion people, had fewer than two theatres per 100 000. Pulse oximetry data from 54 countries suggested that around 77 700 (63 195—95 533) theatres worldwide (19·2% [15·2—23·9]) were not equipped with pulse oximeters.

Interpretation: Improvements in public-health strategies and monitoring are needed to reduce disparities for more than 2 billion people without adequate access to surgical care.

 

Funding: WHO……………”

 

*      *     *

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.
------------------------------------------------------------------------------------
PAHO/WHO Website
Equity List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho

IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission. 

Thank you.