RetroSearch Browse

Home - News ( United States | United Kingdom | Italy | Germany ) - Football scores

Showing content from https://pubmed.ncbi.nlm.nih.gov/25926087/ below:

Global access to surgical care: a modelling study

doi: 10.1016/S2214-109X(15)70115-4. Epub 2015 Apr 27. Global access to surgical care: a modelling study Nakul P Raykar², Mark G Shrime³, Thomas G Weiser⁴, Stephen W Bickler⁵, John A Rose⁶, Cameron T Nutt⁷, Sarah L M Greenberg⁸, Meera Kotagal⁹, Johanna N Riesel¹⁰, Micaela Esquivel⁴, Tarsicio Uribe-Leitz⁴, George Molina¹¹, Nobhojit Roy¹², John G Meara¹³, Paul E Farmer¹⁴

Affiliations

¹ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, USA.
² Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Department of Surgery, Beth Israel Deaconess Medical Center, Boston, USA. Electronic address: nraykar@bidmc.harvard.edu.
³ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Office of Global Surgery and Health, Massachusetts Eye and Ear Infirmary, Boston, USA.
⁴ Department of Surgery, Stanford University, Palo Alto, USA.
⁵ Rudy Children's Hospital, University of California, San Diego, CA, USA.
⁶ Department of Surgery, University of California, San Diego, CA, USA.
⁷ Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA.
⁸ Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, USA; Department of Surgery, Medical College of Wisconsin, Wauwatosa, USA.
⁹ Department of Surgery, University of Washington, Seattle, USA.
¹⁰ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Department of Surgery, Massachusetts General Hospital, Boston, USA.
¹¹ Ariadne Labs, Boston, USA; Department of Surgery, Massachusetts General Hospital, Boston, USA.
¹² Department of Surgery, BARC Hospital, Mumbai, India; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
¹³ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, USA.
¹⁴ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, USA; Partners-In-Health, Boston, USA.

PMID: 25926087
PMCID: PMC4820251
DOI: 10.1016/S2214-109X(15)70115-4

Item in Clipboard

Global access to surgical care: a modelling study

Blake C Alkire et al. Lancet Glob Health. 2015 Jun.

doi: 10.1016/S2214-109X(15)70115-4. Epub 2015 Apr 27. Authors Blake C Alkire¹, Nakul P Raykar², Mark G Shrime³, Thomas G Weiser⁴, Stephen W Bickler⁵, John A Rose⁶, Cameron T Nutt⁷, Sarah L M Greenberg⁸, Meera Kotagal⁹, Johanna N Riesel¹⁰, Micaela Esquivel⁴, Tarsicio Uribe-Leitz⁴, George Molina¹¹, Nobhojit Roy¹², John G Meara¹³, Paul E Farmer¹⁴ Affiliations

¹ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, USA.
² Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Department of Surgery, Beth Israel Deaconess Medical Center, Boston, USA. Electronic address: nraykar@bidmc.harvard.edu.
³ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Office of Global Surgery and Health, Massachusetts Eye and Ear Infirmary, Boston, USA.
⁴ Department of Surgery, Stanford University, Palo Alto, USA.
⁵ Rudy Children's Hospital, University of California, San Diego, CA, USA.
⁶ Department of Surgery, University of California, San Diego, CA, USA.
⁷ Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA.
⁸ Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, USA; Department of Surgery, Medical College of Wisconsin, Wauwatosa, USA.
⁹ Department of Surgery, University of Washington, Seattle, USA.
¹⁰ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Department of Surgery, Massachusetts General Hospital, Boston, USA.
¹¹ Ariadne Labs, Boston, USA; Department of Surgery, Massachusetts General Hospital, Boston, USA.
¹² Department of Surgery, BARC Hospital, Mumbai, India; Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
¹³ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, USA.
¹⁴ Program in Global Surgery and Social Change, Harvard Medical School, Boston, USA; Division of Global Health Equity, Brigham and Women's Hospital, Boston, USA; Partners-In-Health, Boston, USA.

PMID: 25926087
PMCID: PMC4820251
DOI: 10.1016/S2214-109X(15)70115-4

Item in Clipboard

Abstract

Background: More than 2 billion people are unable to receive surgical care based on operating theatre density alone. The vision of the Lancet Commission on Global Surgery is universal access to safe, affordable surgical and anaesthesia care when needed. We aimed to estimate the number of individuals worldwide without access to surgical services as defined by the Commission's vision.

Methods: We modelled access to surgical services in 196 countries with respect to four dimensions: timeliness, surgical capacity, safety, and affordability. We built a chance tree for each country to model the probability of surgical access with respect to each dimension, and from this we constructed a statistical model to estimate the proportion of the population in each country that does not have access to surgical services. We accounted for uncertainty with one-way sensitivity analyses, multiple imputation for missing data, and probabilistic sensitivity analysis.

Findings: At least 4·8 billion people (95% posterior credible interval 4·6-5·0 [67%, 64-70]) of the world's population do not have access to surgery. The proportion of the population without access varied widely when stratified by epidemiological region: greater than 95% of the population in south Asia and central, eastern, and western sub-Saharan Africa do not have access to care, whereas less than 5% of the population in Australasia, high-income North America, and western Europe lack access.

Interpretation: Most of the world's population does not have access to surgical care, and access is inequitably distributed. The near absence of access in many low-income and middle-income countries represents a crisis, and as the global health community continues to support the advancement of universal health coverage, increasing access to surgical services will play a central role in ensuring health care for all.

Funding: None.

PubMed Disclaimer

Conflict of interest statement

Declaration of interests

We declare no competing interests.

Figures
Figure 1. Chance tree to assess global…

Figure 1. Chance tree to assess global access to surgical care

Each chance node represents…

Figure 1. Chance tree to assess global access to surgical care

Each chance node represents a dimension of access.

Figure 2

Posterior probability of global population…

Figure 2

Posterior probability of global population without access to surgery

Figure 2

Posterior probability of global population without access to surgery

Figure 3. Proportion of population without access…

Figure 3. Proportion of population without access to surgery by Institute for Health Metrics and…
Figure 3. Proportion of population without access to surgery by Institute for Health Metrics and Evaluation global burden of disease super region

GBD=global burden of disease. Error bars=95% posterior credible interval.

Figure 4

Proportion of population without access…

Figure 4

Proportion of population without access to surgery by country (selective tree with baseline…

Figure 4

Proportion of population without access to surgery by country (selective tree with baseline assumptions)

Comment in

The surgery spring.
Mullan Z. Mullan Z. Lancet Glob Health. 2015 Jun;3(6):e297. doi: 10.1016/S2214-109X(15)00015-7. Epub 2015 May 12. Lancet Glob Health. 2015. PMID: 25979513 No abstract available.
Global access to surgical care: moving forward.
Wong EG, Deckelbaum DL, Razek T. Wong EG, et al. Lancet Glob Health. 2015 Jun;3(6):e298-9. doi: 10.1016/S2214-109X(15)00004-2. Lancet Glob Health. 2015. PMID: 26001569 No abstract available.
Strengthening health systems through surgery.
Nepogodiev D, Ismail L, Meara JG, Roslani AC, Harrison EM, Bhangu A. Nepogodiev D, et al. Lancet. 2024 Jun 1;403(10442):2358-2360. doi: 10.1016/S0140-6736(24)01031-6. Epub 2024 May 20. Lancet. 2024. PMID: 38782001 No abstract available.