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Projections for Achieving the Lancet Commission Recommended Surgical Rate of 5000 Operations per 100,000 Population by Region-Specific Surgical Rate Estimates

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Abstract

Background

We previously identified a range of 4344–5028 annual operations per 100,000 people to be related to desirable health outcomes. From this and other evidence, the Lancet Commission on Global Surgery recommends a minimum rate of 5000 operations per 100,000 people. We evaluate rates of growth and estimate the time it will take to reach this minimum surgical rate threshold.

Methods

We aggregated country-level surgical rate estimates from 2004 to 2012 into the twenty-one Global Burden of Disease (GBD) regions. We calculated mean rates of surgery proportional to population size for each year and assessed the rate of growth over time. We then extrapolated the time it will take each region to reach a surgical rate of 5000 operations per 100,000 population based on linear rates of change.

Results

All but two regions experienced growth in their surgical rates during the past 8 years. Fourteen regions did not meet the recommended threshold in 2012. If surgical capacity continues to grow at current rates, seven regions will not meet the threshold by 2035. Eastern Sub-Saharan Africa will not reach the recommended threshold until 2124.

Conclusion

The rates of growth in surgical service delivery are exceedingly variable. At current rates of surgical and population growth, 6.2 billion people (73 % of the world’s population) will be living in countries below the minimum recommended rate of surgical care in 2035. A strategy for strengthening surgical capacity is essential if these targets are to be met in a timely fashion as part of the integrated health system development.

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Conflicts of interest

We declare that we have no conflicts of interest.

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Authors and Affiliations

  1. Department of Surgery, Stanford University, School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Tarsicio Uribe-Leitz, Micaela M. Esquivel & Thomas G. Weiser

  2. Ariadne Labs, Brigham and Women’s Hospital and Harvard TH Chan School of Public Health, 401 Park Drive, Third Floor East, Boston, MA, 02215, USA

    George Molina, Stuart R. Lipsitz, Atul A. Gawande & Alex B. Haynes

  3. Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA

    George Molina & Alex B. Haynes

  4. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA

    Stéphane Verguet

  5. Center for Surgery and Public Health, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115, USA

    John Rose

  6. Division of Pediatric Surgery, Rady Children’s Hospital, University of California San Diego, 3020 Children’s Way, San Diego, CA, 92123, USA

    John Rose & Stephen W. Bickler

Authors
  1. Tarsicio Uribe-Leitz
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  2. Micaela M. Esquivel
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  3. George Molina
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  4. Stuart R. Lipsitz
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  5. Stéphane Verguet
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  6. John Rose
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  7. Stephen W. Bickler
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  8. Atul A. Gawande
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  9. Alex B. Haynes
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  10. Thomas G. Weiser
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Corresponding author

Correspondence to Tarsicio Uribe-Leitz.

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Uribe-Leitz, T., Esquivel, M.M., Molina, G. et al. Projections for Achieving the Lancet Commission Recommended Surgical Rate of 5000 Operations per 100,000 Population by Region-Specific Surgical Rate Estimates. World J Surg 39, 2168–2172 (2015). https://doi.org/10.1007/s00268-015-3113-6

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  • DOI: https://doi.org/10.1007/s00268-015-3113-6

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