Rolle Myron L, Williams Ashley, Boeykens Annegien, Garba Deen L, McLellan Rachel, Francis Michael, Dos Santos Rubio Ellianne
Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Oakland University William Beaumont School of Medicine, Rochester, Michigan, USA.
World Neurosurg. 2023 Nov;179:e150-e159. doi: 10.1016/j.wneu.2023.08.039. Epub 2023 Aug 18.
The neurosurgical workforce in the Caribbean and surrounding countries is largely unknown due to the diversity in cultural, linguistic, political, financial disparities, and colonial history between the countries. About 45 neurosurgeons serve 16 million people in the Caribbean Community and Common Market, a trade alliance including most Caribbean nations. We aimed to understand the current scope of neurosurgical workforce in this region while highlighting any system challenges and potential solutions for upscaling the workforce.
We surveyed neurosurgeons within Caribbean countries and surrounding countries online using qualitative and quantitative methods via Qualtrics.
Of the 38 countries within the Caribbean and surrounding countries, 26 (68%) were surveyed and of which 18 (69%) replied. In total, 172 regional neurosurgeons were identified, of which 61 (35%) replied-with a majority of general neurosurgeons (56%). Remarkably, the majority of countries failed to meet the threshold workforce density for safe health care-either expressed by full-time equivalent neurosurgeons or neurosurgical centers (see table). Most neurosurgical practices confirmed receiving or sending medical referrals. If so, most referrals took longer than 8 hours without significant difference regarding the destination. Lastly, challenges confronting neurosurgical advancement were found in the following: technology and equipment (40%), trained personnel (31%), hospital or medical center infrastructure (14%), neurosurgical education, and training (44%).
To our knowledge, this is the first qualitative and quantitative study exploring the current status of the neurosurgical workforce within the Caribbean and surrounding countries. Identifying resources and challenges can contribute to improving regionalized neurosurgical care.
由于加勒比地区及周边国家在文化、语言、政治、财政差异以及殖民历史方面存在多样性，该地区神经外科医疗人力情况很大程度上尚不为人所知。在加勒比共同体和共同市场（一个包括大多数加勒比国家的贸易联盟）中，约45名神经外科医生为1600万人提供服务。我们旨在了解该地区神经外科医疗人力的当前规模，同时突出任何系统挑战以及扩大人力规模的潜在解决方案。
我们通过Qualtrics在线使用定性和定量方法对加勒比国家及周边国家的神经外科医生进行了调查。
在加勒比地区及周边的38个国家中，26个（68%）接受了调查，其中18个（69%）作出了回复。总共确定了172名区域神经外科医生，其中61名（35%）作出了回复，大多数为普通神经外科医生（56%）。值得注意的是，如果以全职等效神经外科医生或神经外科中心来衡量，大多数国家未能达到安全医疗所需的人力密度阈值（见表）。大多数神经外科业务确认接收或发送过医疗转诊。如果是这样，则大多数转诊耗时超过8小时，且目的地之间没有显著差异。最后，在以下方面发现了神经外科发展面临挑战：技术和设备（40%）、训练有素的人员（31%）、医院或医疗中心基础设施（14%）、神经外科教育和培训（44%）。
据我们所知这是第一项探索加勒比地区及周边国家神经外科医疗人力现状的定性和定量研究。确定资源和挑战有助于改善区域神经外科护理。
