Article
Elective surgery system strengthening development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries
Author/s | Tallón Aguilar, Luis
Capitan-Morales, Luis-Cristobal Gómez Rosado, Juan Carlos |
Department | Universidad de Sevilla. Departamento de Cirugía |
Publication Date | 2022-10-31 |
Deposit Date | 2023-05-10 |
Published in |
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Abstract | Background
The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around ... Background The 2015 Lancet Commission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs. Methods First, we performed an international consultation through a four-stage consensus process to develop a multidomain index for hospital-level assessment (surgical preparedness index; SPI). Second, we measured surgical preparedness across a global network of hospitals in high-income countries (HICs), middle-income countries (MICs), and low-income countries (LICs) to explore the distribution of the SPI at national, subnational, and hospital levels. Finally, using COVID-19 as an example of an external system shock, we compared hospitals' SPI to their planned surgical volume ratio (SVR; ie, operations for which the decision for surgery was made before hospital admission), calculated as the ratio of the observed surgical volume over a 1-month assessment period between June 6 and Aug 5, 2021, against the expected surgical volume based on hospital administrative data from the same period in 2019 (ie, a pre-pandemic baseline). A linear mixed-effects regression model was used to determine the effect of increasing SPI score. |
Funding agencies | Association of Coloproctology of Great Britain and Ireland Bowel Research UK British Association of Surgical Oncology British Gynaecological Cancer Society, and Medtronic National Institute for Health Research (NIHR) Global Health Research Unit Grant NIHR Doctoral Research Fellowship Royal College of Surgeons of England COVID-19 recovery research group |
Project ID. | 16.136.79
NIHR300175 |
Citation | Tallón Aguilar, L., Capitan-Morales, L. y Gómez Rosado, J.C. (2022). Elective surgery system strengthening development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries. The Lancet, 400 (10363), 1607-1617. https://doi.org/10.1016/S0140-6736(22)01846-3. |
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