Quality of essential surgical care in low- and middle-income countries: a systematic review of the literature

International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care
Saurabh SalujaMark G Shrime

Abstract

Quality of care is an emerging area of focus in the surgical disciplines. However, much of the emphasis on quality is limited to high-income countries. To address this gap, we conducted a systematic review of the literature on the quality of essential surgical care in low- and middle- income countries (LMIC). We searched PubMed, Cinahl, Embase and CAB Abstracts using three domains: quality of care, surgery and LMIC. We limited our review to studies of essential surgeries that pertained to all three search domains. We extracted data on study characteristics, type of surgery and the way in which quality was studied. 354 studies were included. 281 (79.4%) were single-center studies and nearly half (n = 169, 46.9%) did not specify the level of facility. 207 studies reported on mortality (58.47%) and 325 reported on a morbidity (91.81%), most commonly surgical site infection (n = 190, 53.67%). Of the Institute of Medicine domains of quality, studies were most commonly of safety (n = 310, 87.57%) and effectiveness (n = 180, 50.85%) and least commonly of equity (n = 21, 5.93%). We find that while there are numerous studies that report on some aspects of quality of care, much of the data is single center and observational. Additionally...Continue Reading

References

May 10, 2001·Journal of the American Veterinary Medical Association·M J LeslieF E Sorhage
Jan 31, 2002·The Journal of School Health·M K Tappe, R A Galer-Unti
Mar 31, 2004·Journal of the American College of Surgeons·John D BirkmeyerNancy J O Birkmeyer
Jan 16, 2009·The New England Journal of Medicine·Alex B HaynesUNKNOWN Safe Surgery Saves Lives Study Group
Sep 21, 2013·BMJ Quality & Safety·Ashish K JhaDavid W Bates
Jul 6, 2014·The New England Journal of Medicine·Kirstin W Scott, Ashish K Jha
Dec 23, 2014·Diabetes Research and Clinical Practice·Roopa ShivashankarMahammed K Ali
Feb 11, 2015·Lancet·Charles N MockUNKNOWN DCP3 Essential Surgery Author Group

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Citations

Mar 29, 2019·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Usman IqbalYu-Chuan Jack Li
Jan 7, 2020·Anaesthesia·V SanthirapalaC D McClain
Dec 19, 2020·The Journal of Bone and Joint Surgery. American Volume·Lauren M Shapiro, UNKNOWN Global Quality in Upper Extremity Surgery and Training (Global QUEST) Investigators
Jun 9, 2021·BMJ Quality & Safety·Tihitena Negussie Mammo, Thomas G Weiser
Jun 1, 2021·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Shehnaz AlidinaSarah Maongezi

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