Harvard Humanitarian Initiative, Harvard University, Cambridge, MA, USA.
World J Surg. 2010 Mar;34(3):397-402. doi: 10.1007/s00268-009-0181-5.
Emerging data demonstrate that a large fraction of the global burden of disease is amenable to surgical intervention. There is a paucity of data related to delivery of surgical care in low- and middle-income countries, and no aggregate data describe the efforts of international organizations to provide surgical care in these settings. This study was designed to describe the roles and practices of international organizations delivering surgical care in developing nations with regard to surgical types and volume, outcomes tracking, and degree of integration with local health systems.
Between October 2008 and December 2008, an Internet-based confidential questionnaire was distributed to 99 international organizations providing humanitarian surgical care to determine their size, scope, involvement in surgical data collection, and integration into local systems.
Forty-six international organizations responded (response rate 46%). Findings reveal that a majority of organizations that provide surgery track numbers of cases performed and immediate outcomes, such as mortality. In general, these groups have mechanisms in place to track volume and outcomes, provide for postintervention follow-up, are committed to providing education, and work in conjunction with local health organizations and providers. Whereas most organizations surveyed provided fewer than 500 surgical procedures annually, more than half had the capacity to provide emergency services. In addition, a great diversity of specialized surgical care was provided, including obstetrics, orthopedic, plastic, and ophthalmologic surgery.
International organizations providing surgical services are diverse in size and breadth of surgical services provided yet, with consistency, provide rudimentary analysis, postoperative follow-up care, and both education and integration of health services at the local level. The role of international organizations in the delivery of surgery is an important index, worthy of further evaluation.
新出现的数据表明，全球疾病负担的很大一部分可以通过手术干预来解决。关于中低收入国家提供外科护理的资料很少，也没有综合数据描述国际组织在这些环境中提供外科护理的努力。本研究旨在描述在发展中国家提供外科护理的国际组织在手术类型和数量、结果跟踪以及与当地卫生系统整合程度方面的作用和做法。
2008 年 10 月至 2008 年 12 月期间，通过互联网向 99 个提供人道主义外科护理的国际组织分发了一份机密问卷，以确定它们的规模、范围、参与外科数据收集的情况以及与当地系统的整合程度。
46 个国际组织作出回应（回应率为 46%）。调查结果显示，大多数提供外科手术的组织都在跟踪手术数量和即时结果，如死亡率。一般来说，这些团体都有机制来跟踪数量和结果，提供干预后的随访，致力于提供教育，并与当地卫生组织和提供者合作。虽然大多数接受调查的组织每年提供的手术少于 500 例，但超过一半的组织有能力提供紧急服务。此外，还提供了各种专业的外科护理，包括产科、骨科、整形和眼科手术。
提供外科服务的国际组织在规模和提供的外科服务广度上各不相同，但一致性地提供了基本分析、术后随访护理以及当地卫生服务的教育和整合。国际组织在提供手术方面的作用是一个重要的指标，值得进一步评估。
