TRENDS IN SURGICAL CASE VOLUME REPORTING IN THE UNITED STATES: A DECADE AFTER THE LANCET COMMISSION athompson24@mgb.org

PE033

TRENDS IN SURGICAL CASE VOLUME REPORTING IN THE UNITED STATES: A DECADE AFTER THE LANCET COMMISSION

8

 

 

 

 

United States

Oral or Poster

Despite significant healthcare resources, there is limited national data on surgical volume (SV) in the United States (US). The Lancet Commission on Global Surgery (LCoGS) proposed an annual target of 5000 cases per 100,000 population by 2030 as an indicator of a health system’s capacity to provide surgical care. We aimed to quantify SV and evaluate reporting practices in the US compared against the LCoGS benchmark and World Development Indicators (WDI) estimates.

We performed a scoping review, searched 5 databases, and identified articles published through 2024. Using a published protocol, we included articles reporting national-level SV rates in the US. Data screening and extraction were performed in Covidence.

Of 2832 abstracts, 28(0.99%) were included. No article reported national SV per 100,000 per year. Specialties most commonly reporting SV were orthopedics(n=9;32%), neurosurgery(n=5;18%), gynecology(n=5;18%), and general surgery (n=5;18%). Reporting practices were heterogeneous with 46%(n=13) reporting SV per 100,000 total population and practices remained unchanged after the global targets were proposed in 2015 (p=0.57). While the World Bank’s WDI estimates a US SV of 12,087/100,000, we calculated a composite SV of 2399/100,000 based on published rates (only 20% of expected), suggesting considerable underreporting.

Our calculated SV significantly underestimates actual SV based on the WDI, and falls below the LCoGS benchmark for 2030. A regular and standardized approach to national SV reporting in the US is needed to benchmark progress and enable surgical system strengthening in the US and abroad.