Vervoort Dominique, Lee Grace, Ghandour Hiba, Guetter Camila R, Adreak Najah, Till Brian M, Lin Yihan
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Ann Thorac Surg Short Rep. 2023 Dec 9;2(2):320-324. doi: 10.1016/j.atssr.2023.11.019. eCollection 2024 Jun.
More than 1 million cardiac surgical procedures are estimated to occur yearly. Little is known about country-level procedural estimates and volumes needed to provide adequate population coverage. We evaluated annual cardiac procedural volumes for high-income countries and present target volumes for countries to work toward as part of universal health coverage agendas.
Academic and gray literature was searched for total annual volumes for high-income countries for all cardiac surgery, coronary artery bypass grafting (CABG), valvular surgery, and congenital heart surgery between 2010 and 2021. Matched populations were obtained from the World Bank World Development Indicators. Volume targets by country income group were proposed on the basis of published expert opinion and adjusted for cardiovascular disease burdens.
An average total cardiac surgical volume of 123.2 per 100,000 population per year was performed in high-income countries (36.7 CABG, 30.8 valvular, 7.9 congenital). Unadjusted annual volume targets per 100,000 population for low- and middle-income countries are 61.6 cardiac surgical procedures, 18.3 CABGs, 15.4 valvular surgical procedures, and 4.0 congenital heart operations. Adjusted for cardiovascular disease burdens, total cardiac surgical volume targets are 86.1 procedures per 100,000 population per year for upper-middle-income countries, 55.1 for lower-middle-income countries, and 40.2 for low-income countries.
Target annual procedural volumes present opportunities to strategically work toward expanding cardiac surgical capacity to meet the needs of countries' populations. These targets may guide country-specific targets, which should be optimized through the expert opinion and lived experiences of local health care professionals and the context-specific population needs.
据估计，每年进行的心脏外科手术超过100万例。关于国家层面的手术估计数以及提供足够人口覆盖所需的手术量，人们了解甚少。我们评估了高收入国家的年度心脏手术量，并提出了各国作为全民健康覆盖议程一部分应努力实现的目标手术量。
检索学术文献和灰色文献，以获取2010年至2021年期间高收入国家所有心脏手术、冠状动脉旁路移植术（CABG）、瓣膜手术和先天性心脏病手术的年度总量。匹配的人口数据来自世界银行世界发展指标。根据已发表的专家意见提出按国家收入组划分的手术量目标，并根据心血管疾病负担进行调整。
高收入国家每年每10万人口平均进行123.2例心脏外科手术（36.7例CABG、30.8例瓣膜手术、7.9例先天性心脏病手术）。低收入和中等收入国家每10万人口未经调整的年度手术量目标是61.6例心脏外科手术、18.3例CABG、15.4例瓣膜手术和4.0例先天性心脏病手术。根据心血管疾病负担进行调整后，上中等收入国家每年每10万人口的心脏外科手术总量目标为86.1例，下中等收入国家为55.1例，低收入国家为40.2例。
目标年度手术量为战略性地努力扩大心脏外科手术能力以满足各国人口需求提供了机会。这些目标可指导各国制定具体目标，而具体目标应通过当地医疗保健专业人员的专家意见和实际经验以及特定背景下的人口需求进行优化。
