Challenges faced by acute care surgeons in China
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(2019) 14:16
COMMENTARY
Open Access
Challenges faced by acute care surgeons in China Dequan Xu, Limin Hou* and Haoxin Zhou
Abstract The aim of this article is to describe briefly about Chinese ACS surgeons’ work status. It is an undeniable fact that the analysis of ED and ACS resources shows negative tendencies and high work overload, resulting in low patient safety and quality of care. And, there was a substantial shortage of surgeons in the subspecialty. So, a set of strategic measures and state policies should be prioritized. Keywords: ACS, Elderly patients, ED visits, EGS
Background Acute care surgery (ACS) as a distinct subspecialty within general surgical practice has been in existence for over a decade [1, 2] (Fig. 1). Although often used interchangeably, “emergency general surgery (EGS)” and “ACS” have different meanings. Whereas EGS refers to acute general surgical disorders, ACS includes surgical critical care and the surgical management of acutely ill patients with a variety of conditions including trauma, burns, surgical critical care, or an acute general surgical condition [3] (Fig. 2). Previous studies have demonstrated the improvement in injury-related mortality and length of stay in hospital systems that use ACS model [4, 5]. China’s rapid economic growth and resulting demands for modern health care have resulted in heavy pressure on ACS surgeons. Chinese ACS surgeons are overworked, suffer lack of respect, and faced the possibility of serious employee turnover. As a consequence, they are faced with some dilemmas in China, which need to be settled urgently. Main text Concerns from population growth
By the end of 2016, China’s population approached 1.38 billion. Despite its rapid economic development, China has not seen its health care system keep pace. * Correspondence: [email protected] Department of Emergency Surgery, First Affiliated Hospital of Harbin Medical University, 23 Youzheng Street, Nangang District, Harbin 150001, Heilongjiang Province, People’s Republic of China
In 2016, China had 2.31 licensed (assistant) doctors per 1000 population, which was substantially lower than other countries. In China, hospitals have noted an increased acuity of patients presenting to them. According to the “2017 China Health Statistical Yearbook Compiled by the National Health and Family Planning Commission (http://www.yearbookchina.com/),” the number of outpatients in hospitals has increased significantly from 2,483,091,057 in 2012 to 3,197,103,337 in 2016 over a 5-year period. The population of medical practitioners, outpatients, and emergency department (ED) visits in Chinese hospitals during the years 2012– 2016 is shown in Table 1. From the present statistical data, the population of medical practitioners, outpatients, and ED visits had grown over 29.5%, 28.8%, and 39.5% by 2016 relative to the 2012 baseline, respectively. The ED visit population grew at a faster rate than the previous two. The trend in the number of ED visits in Chinese hospitals from 2012 to 2016 is shown in Fig. 3. Unavoidable
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