S Afr Med J. 2011 Jul 25;101(8):521-2.
Surgical disease is an important cause of preventable mortality and morbidity, but it is not clear how best to deliver surgical services to under-served rural populations in poorer countries. South Africa's policy is to restructure heath services, with district hospitals and health centres becoming the primary delivery vehicle for quality health care to all South Africans. Among other things this involves defining what services a district hospital should be expected to provide, including the district hospital service package (DHSP). Many felt that the list of district hospital surgical procedures is unrealistic, and it is not clear to what extent the package is deliverable. We therefore studied the operative surgery undertaken at district hospital level in a single region with well-organised primary health care services.
外科疾病是可预防的死亡和发病的一个重要原因，但目前尚不清楚如何以最佳方式向较贫穷国家服务不足的农村人口提供外科服务。南非的政策是重组卫生服务，使地区医院和保健中心成为向所有南非人提供优质保健的主要服务手段。除其他事项外，这涉及确定地区医院应提供哪些服务，包括地区医院服务一揽子计划。许多人认为地区医院外科手术清单不切实际，也不清楚该一揽子计划在多大程度上可以实现。因此，我们研究了在一个具有良好组织的初级保健服务的单一地区进行的地区医院级手术。
