Background
Surgical delivery varies 200-fold across countries. No direct correlation exists,
however, between surgical delivery and health outcomes, making it difficult to pinpoint
a goal for surgical scale-up. This report determines the amount of surgery that would
be delivered worldwide if the world aligned itself with countries providing the best
health outcomes.
Methods
Annual rates of surgical delivery have been published previously for 129 countries.
Five health outcomes were plotted against reported surgical delivery. Univariate and
multivariate polynomial regression curves were fit, and the optimal point on each
regression curve was determined by solving for first-order conditions. The country
closest to the optimum for each health outcome was taken as representative of the
best-performing health system. Monetary inputs to and surgical procedures provided
by these systems were scaled to the global population.
Results
For 3 of the 5 health outcomes, optima could be found. Globally, 315 million procedures
currently are provided annually. If global delivery mirrored the 3 best-performing
countries, between 360 million and 460 million cases would be provided annually. With
population growth, this will increase to approximately half a billion cases by 2030.
Health systems delivering these outcomes spend approximately 10% of their GDP on health.
Conclusion
This is the first study to provide empirical evidence for the surgical output that
an ideal health system would provide. Our results project ideal delivery worldwide
of approximately 550 million annual surgical cases by 2030.
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Article info
Publication history
Published online: April 28, 2015
Accepted:
March 26,
2015
Footnotes
M.G.S. received partial funding from National Institutes of Health/National Cancer Institute R25CA92203.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
