Defining the critical pediatric surgical workforce density for improving surgical outcomes: a global study
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Read the article on jpedsurg.org ↗Article · Dec 2019 · 1 min read
In brief
In brief
Global analysis of 86 countries reveals critical threshold of 4 pediatric surgeons per million children correlates with 80% survival rates. LMICs with 19% of surgical workforce see dramatically lower survival (42%) compared to high-income countries (92%) for conditions like gastroschisis and esophageal atresia.
Written by the GCMD Library team from the article.
Purpose
Low- and middle-income countries (LMICs) have only 19% of the global surgical workforce yet see 80% of worldwide deaths from noncommunicable diseases. We aimed to interrogate the correlation between pediatric surgical workforce density (PSWD) and survival from pediatric surgical conditions worldwide.
Methods
A systematic review of online databases identified outcome studies for key pediatric surgical conditions (gastroschisis, esophageal atresia, intestinal atresia, and typhoid perforation) as well as PSWD data across low-income (LICs), middle-income (MICs), and high-income countries (HICs). PSWD was expressed as the number of PSs/million children under 15 years of age and we correlated this to surgical outcomes for our case series.
Results
PSWD ranged between zero (Burundi, The Gambia, and Mauritania) and 125.2 (Poland) across 86 countries. Outcomes for at least one condition were obtained in 61 countries: 50 outcomes in HICs, 52 in MICs and 8 in LICs. The mean survival in our case series was 42.3%, 69.4% and 91.6% for LICs, MICs, and HICs, respectively. A PSWD ≥4 PSs/million children under 15 years of age significantly correlated to odds of survival ≥80% (OR 16.8, p