International Research Fellow, Plastic Surgery Section, University of Michigan, Ann Arbor, MI, United States; Department of Hand Surgery, Nagoya University, Nagoya, Japan.
Research Associate, University of Michigan Medical School, Ann Arbor, MI, United States.
Int J Surg. 2017 Aug;44:56-63. doi: 10.1016/j.ijsu.2017.06.036. Epub 2017 Jun 15.
Economic downturn can have a wide range of effects on medicine at both individual and national levels. We aim to describe these effects in relation to surgical volume to guide future planning for physician specialization, patient expectations in the face of economic crises, or estimating healthcare expenditure. We hypothesized that because of high out-of-pocket costs, cosmetic procedure volumes would be most affected by economic decline.
A systematic review was conducted using MEDLINE, Embase, and ABI/INFORMS. The main search terms were "economic recession" and "surgical procedures, operative". Studies were included if surgical volumes were measured and economic indicators were used as predictors of economic conditions.
Twelve studies were included, and the most common subject was cosmetic (n = 5), followed by orthopedic (n = 2) and cardiac surgeries (n = 2). The majority of studies found that in periods of economic downturn, surgical volume decreased. Among the eight studies using Pearson's correlation analysis, there were no significant differences between cosmetic procedures and other elective procedures, indicating that cosmetic procedures may display trends similar to those of non-cosmetic elective procedures in periods of economic downturn.
Surgical volume generally decreased when economic indicators declined, observed for both elective and non-elective surgery fields. However, a few specific procedure volumes such as vasectomy and caesarean section for male babies increased during the economic downturn. Knowledge of these trends can be useful for future surgical planning and distribution of healthcare resources.
经济衰退会对个人和国家层面的医学产生广泛影响。我们旨在描述这些与手术量相关的影响，以指导未来医生专业化规划、患者在经济危机面前的预期，或估算医疗支出。我们假设，由于自费费用较高，美容手术量受经济衰退的影响最大。
采用 MEDLINE、Embase 和 ABI/INFORMS 进行系统综述。主要检索词为“经济衰退”和“手术程序，操作性”。如果测量了手术量且经济指标被用作经济状况的预测因素，则纳入研究。
共纳入 12 项研究，最常见的主题是美容（n=5），其次是矫形（n=2）和心脏手术（n=2）。大多数研究发现，在经济衰退期间，手术量减少。在使用 Pearson 相关分析的 8 项研究中，美容手术与其他择期手术之间没有显著差异，这表明在经济衰退期间，美容手术可能与非美容择期手术显示出相似的趋势。
当经济指标下降时，手术量通常会减少，无论是择期手术还是非择期手术领域都是如此。然而，在经济衰退期间，某些特定手术量（如男性婴儿的输精管切除术和剖宫产术）有所增加。了解这些趋势对未来的手术规划和医疗资源分配很有用。
