Estimation of the National Surgical Needs in India by Enumerating the Surgical Procedures in an Urban Community Under Un
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SURGERY IN LOW AND MIDDLE INCOME COUNTRIES
Estimation of the National Surgical Needs in India by Enumerating the Surgical Procedures in an Urban Community Under Universal Health Coverage Prashant Bhandarkar1 • Anita Gadgil2 • Priti Patil1 • Monali Mohan3 • Nobhojit Roy4,5
Accepted: 5 September 2020 Ó The Author(s) 2020
Abstract Background 11% of the global burden of disease requires surgical care or anaesthesia management or both. Some studies have estimated this burden to be as high as 30%. The Lancet Commission for Global Surgery (LCoGS) estimated that 5000 surgeries are required to meet the surgical burden of disease for 100,000 people in LMICs. Studies from LMICs, estimating surgical burden based on enumeration of surgeries, are sparse. Method We performed this study in an urban population availing employees’ heath scheme in Mumbai, India. Surgical procedures performed in 2017 and 2018, under this free and equitable health scheme, were enumerated. We estimated the surgical needs for national population, based on age and sex distribution of surgeries and age standardization from our cohort. Result A total of 4642 surgeries were performed per year for a population of 88,273. Cataract (22.8%), Caesareans (3.8%), surgeries for fractures (3.27%) and hernia (2.86%) were the commonest surgeries. 44.2% of surgeries belonged to the essential surgeries. We estimated 3646 surgeries would be required per 100,000 Indian population per year. One-third of these surgeries would be needed for the age group 30–49 years, in the Indian population. Conclusion A total of 3646 surgeries were estimated annually to meet the surgical needs of Indian population as compared to the global estimate of 5000 surgeries per 100,000 people. Caesarean section, cataract, surgeries for fractures and hernia are the major contributors to the surgical needs. More enumeration-based studies are needed for better estimates from rural as well as other urban areas.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00268-020-05794-7) contains supplementary material, which is available to authorized users. & Nobhojit Roy [email protected] 1
2
Department of Statistics, BARC Hospital, ‘WHO Collaboration Centre for Research in Surgical Care Delivery in LMICs’, Mumbai, India
3
Consultant, ‘WHO Collaboration Centre for Research in Surgical Care Delivery in LMICs’, Mumbai, India
4
Department of Global Public Health, Karolinska Institute, 17177 Stockholm, Sweden
5
WHO Collaboration Centre for Research in Surgical Care Delivery in LMICs, Mumbai, India
Department of Surgery, BARC Hospital, ‘WHO Collaboration Centre for Research in Surgical Care Delivery in LMICs’, Mumbai, India
123
World J Surg
Introduction 11% of the global burden of disease requires surgical or anaesthesia care or both [1, 2]. The Lancet Commission for Global Surgery (LCoGS) estimated 5000 surgeries are required to meet the surgical burden of diseases of 100,000 people in low- and middle-income countries (LMICs). The reported rates of s
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