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The Impact of Increasing Surgical Capacity at a Tertiary Hospital in Southern Haiti. J Surg Res 2019 07;239:8-13

Date

02/21/2019

Pubmed ID

30782545

DOI

10.1016/j.jss.2019.01.025

Scopus ID

2-s2.0-85061659622   1 Citation

Abstract

BACKGROUND: St. Boniface Hospital (SBH) plays a critical role in providing safe, accessible surgery in rural southern Haiti. We examine the impact of SBH increasing surgical capacity on case volume, patient complexity, and inpatient mortality across three phases.

MATERIALS AND METHODS: A retrospective review and geospatial analysis of all surgical cases performed at SBH between 2015 and 2017 were performed. Inpatient mortality was defined by in-hospital deaths divided by the number of procedures performed.

RESULTS: Between February 2015 and August 2017, over 2000 procedures were performed. The average number of surgeries per week was 3.1 with visiting surgical teams in phase 1 (P1), 10.4 with a single general surgeon in phase 2 (P2), and 20.1 with two surgeons and a resident in phase 3 (P3). There was a six-fold increase in surgical volume between P1 and P3 and a significant increase in case complexity. The distribution of American Society of Anesthesiologists scores of 1, 2, 3, and 4 during P2 was 81.05%, 14.74%, 3.42%, and 0.79%, respectively, whereas in P3, the distribution was 68.91%, 22.55%, 7.70%, and 0.84%. Surgical mortality was 0%, 1.2%, and 1.67% across phases.

CONCLUSIONS: Increasing resources and surgical staff at SBH allowed for greater delivery of safe surgical care. This study highlights that investing in surgery has a significant impact in regions of great surgical need.

Author List

Patterson RH, Bowder AN, Jean-Baptiste T, Eisenson DL, Wilson MK, Dodgion CM, Ward LE, Padovany MMN

Author

Christopher M. Dodgion MD Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Child
Developing Countries
Haiti
Health Resources
Health Services Needs and Demand
Hospital Mortality
Humans
Postoperative Complications
Retrospective Studies
Rural Health Services
Surgical Procedures, Operative
Tertiary Care Centers
Workload