Advertisement

The need to collect, aggregate, and analyze global anesthesia and surgery data

  • Sabrina JuranEmail author
  • Magdalena Gruendl
  • Isobel H. Marks
  • P. Niclas Broer
  • Jose Miguel Guzman
  • Justine Davies
  • Mark Shrime
  • Walter Johnson
  • Hampus Holmer
  • Gregory Peck
  • Emmanuel Makasa
  • Lars Hagander
  • Stephanie J. Klug
  • John G. Meara
  • Adrian W. Gelb
  • David Ljungman
Special Article

Abstract

In the Sustainable Development Goals era, there is a new awareness of the need for an integrated approach to healthcare interventions and a strong commitment to Universal Health Coverage. To achieve the goal of strengthening entire health systems, surgery, as a crosscutting treatment modality, is indispensable. For any health system strengthening exercise, baseline data and longitudinal monitoring of progress are necessary. With improved data capabilities, there are unparalleled possibilities to map out and understand systems, integrating data from many sources and sectors. Nevertheless, there is also a need to prioritize among indicators to avoid information overload and data collection fatigue. There is a similar need to define indicators and collection methodology to create standardized and comparable data. Finally, there is a need to establish data pathways to ensure clear responsibilities amongst national and international institutions and integrate surgical metrics into existing mechanisms for sustainable data collection. This is a call to collect, aggregate, and analyze global anesthesia and surgery data, with an account of existing data sources and a proposed way forward.

La nécessité de collecter, regrouper et analyser les données sur l’anesthésie et la chirurgie dans le monde

Résumé

À l’époque des objectifs du développement durable, on constate une nouvelle sensibilisation au besoin d’une approche intégrée dans les interventions en soins de santé et un fort engagement en faveur d’une couverture médicale universelle. Pour atteindre l’objectif du renforcement de systèmes entiers de santé, la chirurgie en tant que modalité thérapeutique transversale est indispensable. Pour toute activité de renforcement du système de santé, des données de référence et un suivi longitudinal des progrès sont nécessaires. Avec de meilleures données, il existe des possibilités sans équivalent de cartographier et de comprendre les systèmes, en intégrant des données provenant de multiples sources et secteurs. Néanmoins, il est également nécessaire de prioriser les indicateurs pour éviter une surcharge d’informations et une fatigue dans la collecte des données. Il existe un besoin similaire de définition des indicateurs et de la méthodologie de collecte afin de créer des données standardisées et comparables. Enfin, il est nécessaire d’établir des cheminements de données pour garantir des responsabilités claires entre les institutions nationales et internationales et intégrer les paramètres chirurgicaux dans les mécanismes existants pour une collecte durable des données. Ceci est un appel à la collecte, au regroupement et à l’analyse de données globales en anesthésie et en chirurgie avec un compte rendu des sources de données existantes et une proposition d’avancée.

Notes

Conflict of interest

The authors declare no conflicts of interest.

Editorial responsibility

This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.

Author contributions

Sabrina Juran originally conceived of the article and its structure and co-wrote the initial drafts. Magdalena Gruendl helped with significant contributions to the manuscript, including concepts, structure, and wording, and also co-wrote initial drafts and formatted references. Isobel H. Marks helped with significant contributions to the manuscript, including concepts, structure, and wording, and also co-wrote initial drafts. P. Niclas Broer, Jose Miguel Guzman, Justine Davies, Mark Shrimer, Walter Johnson, Hampus Holmer, Gregory Peck, Emmanuel Makasa, Lars Hagander, Stephanie J. Klug, John G. Meara, and Adrian W. Gelb helped with significant contributions to the manuscript, including concepts, structure, and wording. These authors also reviewed the draft. David Ljungman originally conceived of the article and its structure and co-wrote the initial drafts.

Funding sources

David Ljungman is funded by the Fulbright Commission, Swedish Medical Society, Björnsson Foundation, Sweden-America Foundation, and Adlerberth Research Foundation. John G. Meara is supported by an unrestricted grant from General Electric Foundation.

References

  1. 1.
    Price R, Makasa E, Hollands M. Resolution 68.15. Strengthening emergency and essential surgical care and anesthesia as a component of universal health coverage - addressing the public health gaps arising from lack of safe, affordable and accessible surgical and anesthetic services. World Health. Organization 2015; 39: 2115-25.Google Scholar
  2. 2.
    Meara JG, Leather AJ, Hagander L, et al. Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 2015; 386: 569-624.CrossRefGoogle Scholar
  3. 3.
    Shrime MG, Bickler SW, Alkire BC, Mock C. Global burden of surgical disease: an estimation from the provider perspective. Lancet Glob Health 2015; 3(Suppl 2): S8-9.CrossRefGoogle Scholar
  4. 4.
    Alkire BC, Raykar NP, Shrime MG, et al. Global access to surgical care: a modelling study. Lancet Glob Health 2015; 3: e316-23.CrossRefGoogle Scholar
  5. 5.
    Huber B. Finding surgery’s place on the global health agenda. Lancet 2015; 385: 1821-2.CrossRefGoogle Scholar
  6. 6.
    Weiser TG, Haynes AB, Molina G, et al. Size and distribution of the global volume of surgery in 2012. Bull World Health Organ 2016; 94: 201-9FGoogle Scholar
  7. 7.
    Mock CN, Donkor P, Gawande A, et al. Essential Surgery: Key Messages from Disease Control Priorities, 3rd Edition. Lancet 2015; 385: 2209-19.Google Scholar
  8. 8.
    Shrime MG, Dare AJ, Alkire BC, et al. Catastrophic expenditure to pay for surgery worldwide: a modelling study. Lancet Glob Health 2015; 3(Suppl 2): S38-44.CrossRefGoogle Scholar
  9. 9.
    Verguet S, Alkire BC, Bickler SW, et al. Timing and cost of scaling up surgical services in low-income and middle-income countries from 2012 to 2030: a modelling study. Lancet Glob Health 2015; 3(Suppl 2): S28-37.CrossRefGoogle Scholar
  10. 10.
    Alkire BC, Shrime MG, Dare AJ, Vincent JR, Meara JG. Global economic consequences of selected surgical diseases: a modelling study. Lancet Glob Health 2015; 3(Suppl 2): S21-7.CrossRefGoogle Scholar
  11. 11.
    United Nations. World Population Prospects. Key findings & advance tables. 2015 revision. Available from URL: https://esa.un.org/unpd/wpp/publications/files/key_findings_wpp_2015.pdf (accessed August 2018).
  12. 12.
    Kim JY. Opening address to the inaugural “The Lancet Commission on Global Surgery” meeting. The World Bank. Working for a world free of poverty. January 17, 2014 Boston. Available from URL: http://www.globalsurgery.info/wp-content/uploads/2014/01/Jim-Kim-Global-Surgery-Transcribed.pdf (accessed August 2018).
  13. 13.
    World Health Organization. 2017 Seventieth World Health Assembly. Seventieth World Health Assembly Agenda item 16.1 Progress in the implementation of the 2030 agenda for sustainable developement document A70/35. Available from URL: http://www.who.int/life-course/news/events/70-wha/en/ (accessed August 2018).
  14. 14.
    Hosseinpoor AR, Bergen N, Magar V. Monitoring inequality: an emerging priority for health post-2015. Bull World Health Organ 2015; 93: 591-591AGoogle Scholar
  15. 15.
    World Health Organization. Global Reference List of 100 Core Health Indicators (plus health-related SDGs), 2018. Available from URL: http://www.who.int/healthinfo/indicators/2018/en/ (accessed August 2018).
  16. 16.
    The World Bank. DataBank. World Development Indicators. Available from URL: http://databank.worldbank.org/data/reports.aspx?source=world-development-indicators (accessed August 2018).
  17. 17.
    The World Bank. Atlas of Sustainable Development Goals. 2018 - World Development Indicators. Available from URL: http://datatopics.worldbank.org/sdgatlas/ (accessed August 2018).
  18. 18.
    World Health Organization. Fact file on health inequities. 2011. Available from URL: http://www.who.int/sdhconference/background/news/facts/en/ (accessed August 2018).
  19. 19.
    Raykar NP, Ng-Kamstra JS, Bickler S, et al. New global surgical and anaesthesia indicators in the World Development Indicators dataset. BMJ Glob Health 2017; 2: e000265.CrossRefGoogle Scholar
  20. 20.
    Kamali P, Marks I, Sama G, Vervoot D. Measuring surgical systems worldwide: an update. The Data Blog - The World Bank - 2018. Available from URL: https://blogs.worldbank.org/opendata/measuring-surgical-systems-worldwide-update (accessed August 2018).
  21. 21.
    Marks IH, Kamali P, Khan MA, et al. Data for the sustainable development of surgical systems: a global collaboration. WDI surgical indicators data collection 2016. Available from URL: https://docs.wixstatic.com/ugd/d9a674_967bde5252664b709f19e691bf6732fd.pdf (accessed September 2018)
  22. 22.
    The Lancet Commission on Global Surgery. Global Indicator Initiative. Available from URL: http://www.lancetglobalsurgery.org/indicators (accessed August 2018).
  23. 23.
    World Federation of Societies of Anaesthesiologists. World Anaesthesiology Workforce. Available from URL: https://www.wfsahq.org/workforce-map (accessed August 2018).
  24. 24.
    Program in Global Surgery and Social Change - Harvard Medical School. National Surgical, Obstetric and Anesthesia Planning. Available from URL: https://www.pgssc.org/national-surgical-planning (accessed August 2018).
  25. 25.
    Surgeons Overseas SOS. Surgical Need in the Developing World. Available from URL: https://www.surgeonsoverseas.org/resources/ (accessed August 2018).
  26. 26.
    The Lancet Commission on Global Surgery. Implementation Tools. Available from URL: http://www.lancetglobalsurgery.org/implementation-tools (accessed August 2018).
  27. 27.
    Marks IH, Fong ZV, Stapleton SM, Hung YC, Bababekov YJ, Chang DC. How much data are good enough? Using simulation to determine the reliability of estimating pomr for resource-constrained settings. World J Surg 2018; 42: 2344-7.CrossRefGoogle Scholar
  28. 28.
    World Health Organization. Framework and Standards for Country Health Information Systems, Second Edition - 2008. Available frm URL: http://www.who.int/healthinfo/country_monitoring_evaluation/who-hmn-framework-standards-chi.pdf (accessed August 2018).
  29. 29.
    Jha AK, DesRoches CM, Campbell EG, et al. Use of electronic health records in U.S. hospitals. N Engl J Med 2009; 360: 1628-38.CrossRefGoogle Scholar
  30. 30.
    Marques ET Jr, Maciel Filho R, August PN. Overcoming health inequity: potential benefits of a patient-centered open-source public health infostructure. Cad Saude Publica 2008; 24: 547-57.CrossRefGoogle Scholar
  31. 31.
    United Nations. Department for Economic and Social Affairs. Statistics Division. Principles and Recommendations for a Vital Statistics System, Revision 3, 2014. Available from URL: https://unstats.un.org/unsd/demographic/standmeth/principles/m19rev3en.pdf.
  32. 32.
    The DHS Program - Demographic and Health Surverys. The DHS Program - Quality information to plan, monitor and improve population, health, and nutrition programs. Available from URL: https://dhsprogram.com/ (accessed August 2018).
  33. 33.
    United Nations Children’s Fund (UNICEF). Statistics and Monitoring. Multiple Indicator Cluster Survey (MICS). Available from URL: https://www.unicef.org/statistics/index_24302.html (accessed August 2018).
  34. 34.
    Program in Global Surgery and Social Change - Harvard Medical School. Surgical Assessment Tool (SAT). Available from URL: https://www.pgssc.org/national-surgical-planning.
  35. 35.
    Blair KJ, Paladino L, Shaw PL, et al. Surgical and trauma care in low- and middle-income countries: a review of capacity assessments. J Surg Res 2017; 210: 139-51.CrossRefGoogle Scholar
  36. 36.
    The DHS Program - Demographic and Health Surveys. Service Provision Assessment (SPA). Available from URL: https://dhsprogram.com/What-We-Do/Survey-Types/SPA.cfm (accessed August 2018).
  37. 37.
    World Health Organization. Service availability and readiness assessment (SARA) 2015. Available from URL: http://www.who.int/healthinfo/systems/sara_introduction/en/ (accessed August 2018).

Copyright information

© Canadian Anesthesiologists' Society 2018

Authors and Affiliations

  • Sabrina Juran
    • 1
    • 15
    Email author
  • Magdalena Gruendl
    • 1
    • 2
  • Isobel H. Marks
    • 3
  • P. Niclas Broer
    • 4
  • Jose Miguel Guzman
    • 5
  • Justine Davies
    • 6
  • Mark Shrime
    • 2
    • 7
  • Walter Johnson
    • 8
  • Hampus Holmer
    • 9
  • Gregory Peck
    • 10
  • Emmanuel Makasa
    • 11
  • Lars Hagander
    • 9
  • Stephanie J. Klug
    • 1
  • John G. Meara
    • 2
    • 12
  • Adrian W. Gelb
    • 13
  • David Ljungman
    • 2
    • 14
  1. 1.Department of EpidemiologyTechnical University MunichMunichGermany
  2. 2.Program in Global Surgery, Department of Global Health and Social MedicineHarvard Medical SchoolBostonUSA
  3. 3.Northwick Park HospitalImperial College LondonLondonUK
  4. 4.Klinikum BogenhausenTechnical University MunichMunichGermany
  5. 5.The Demographic and Health Survey ProgramICFFairfaxUSA
  6. 6.School of Population Sciences and Health Services Research Faculty of Life Sciences and MedicineKing’s College LondonLondonUK
  7. 7.Department of OtolaryngologyMassachusetts Eye and Ear InfirmaryBostonUSA
  8. 8.World Health OrganizationGenevaSwitzerland
  9. 9.Lund University, WHO Collaborating Centre for Surgery and Public HealthLundSweden
  10. 10.Rutgers Global SurgeryRutgers Biomedical Health SciencesNewarkUSA
  11. 11.Department of Surgery, School of Clinical Medicine, Faculty of Health SciencesUniversity of WitwatersrandJohannesburgSouth Africa
  12. 12.Department of Plastic & Oral Surgery, Boston Children’s HospitalHarvard Medical SchoolBostonUSA
  13. 13.Department of Anaesthesia & Perioperative CareUniversity of California San FranciscoSan FranciscoUSA
  14. 14.Department of Surgery, Institute of Clinical Sciences, Sahlgrenska AcademyUniversity of GothenburgGothenburgSweden
  15. 15.Technical DivisionUnited Nations Population FundNew YorkUSA

Personalised recommendations