Osman G, Kamel Y, Konate I, Diedhiou M, Basnet S, Shrestha R, Shrestha S K, Krylyuk V, Grushka J, Wong E, Farhat T, Khwaja K, Deckelbaum D
Centre for Global Surgery, McGill University, Montreal, Canada.
Faculty of Medicine, University of Montreal, Montreal, Canada.
World J Surg. 2025 Jul;49(7):1848-1857. doi: 10.1002/wjs.12631. Epub 2025 May 31.
The provision of essential and emergency surgical services presents complex challenges in remote areas. Equitable access has gained attention thanks to the significant work done by the Lancet Commission on Global Surgery (LCoGS). Although the focus was on low- and middle-income countries, developed countries also face challenges in providing equitable surgical care and, in fact, do not always meet the benchmarks set by the LCoGS yet still have acceptable outcomes. We sought to explore the current strategies aimed at improving and maintaining access to essential surgical care in rural and remote areas of OECD countries (Organization for Economic Co-operation and Development).
We conducted a scoping review using MeSH terms. The search was performed on MEDLINE and EMBASE databases and was limited to English sources published between 1946 and January 10, 2025.
Any strategy or intervention aimed at improving and maintaining timely access to essential surgeries in rural and remote areas of OECD countries.
Six main categories of strategies were found: (1) resource distribution; (2) task sharing; (3) telemedicine; (4) surgical workforce; (5) training and education; and (6) prehospital system.
Recognizing that developed countries, in fact, do not always meet the benchmarks set by the LCoGS yet still have acceptable outcomes highlights that specific strategies are important contributors to the reduction of disparities between rural and urban outcomes. These strategies may be used in the study of surgical services in low- and middle-income countries.
在偏远地区提供基本和急诊外科服务面临着复杂的挑战。由于《柳叶刀》全球外科委员会（LCoGS）所做的大量工作，公平可及性受到了关注。尽管重点是低收入和中等收入国家，但发达国家在提供公平的外科护理方面也面临挑战，事实上，它们并不总是能达到LCoGS设定的基准，但仍能取得可接受的结果。我们试图探索目前旨在改善和维持经合组织国家（经济合作与发展组织）农村和偏远地区基本外科护理可及性的策略。
我们使用医学主题词进行了一项范围综述。检索在MEDLINE和EMBASE数据库上进行，仅限于1946年至2025年1月10日期间发表的英文文献。
任何旨在改善和维持经合组织国家农村和偏远地区及时获得基本外科手术的策略或干预措施。
发现了六大类策略：（1）资源分配；（2）任务分担；（3）远程医疗；（4）外科劳动力；（5）培训与教育；（6）院前系统。
认识到发达国家事实上并不总是能达到LCoGS设定的基准，但仍能取得可接受的结果，这凸显了特定策略是减少城乡外科服务差距的重要因素。这些策略可用于低收入和中等收入国家的外科服务研究。
