Delays in accessing simple elective surgery in developing countries may create a domino effect and risk people’s lives.
This is according to a new study that analysed the experience of more than 18,000 patients in 640 hospitals across 83 countries.
Using hernia repair to represent elective health care (treatable with simple day-case surgery), researchers concluded that the need for more complex emergency surgery increases substantially if left.
As a result, recovery is delayed and healthcare costs spiral.
Led by the University of Birmingham, the NIHR Global Health Research Unit in Surgery study notes that crisis management of conditions has become the norm, replacing early elective treatment.
Study co-author Dr Maria Picciochi said: ‘Boosting elective surgery for conditions that can be fixed simple and early treatments will reduce the risk of complex, potentially risky, emergency surgery.’
Fellow co-author Professor Aneel Bhangu added, ‘Health policymakers can use our findings as a proxy for other elective conditions, creating a system-strengthening approach to integrate surgery into the wider health care system. This would relieve pressure on emergency pathways and reduce the health burden on society and healthcare services.’
Inguinal hernias are mostly a disease of working-age patients. If neglected, they may require bowel resection, leading to slow recovery and far higher total healthcare costs.
The researchers also found a clear global imbalance in access to mesh repair, reflecting poor access to simple medical devices in lower-income countries. Mesh is well proven to reduce long-term hernia recurrence, is simple to place, low-cost and scalable.
Dr Picciochi added: ‘Our study showed multiple weaknesses in access and quality in current health-care systems, with a particular disadvantage in lower-income settings. As a result, higher emergency demand reduces elective capacity and might create downward spirals. If weak access and quality persist over several electively treatable conditions, both surgical and non-surgical, multimorbidity can also become established, which makes future elective care harder and emergency care even more complicated.’
The study’s findings and its broader implications were due to be discussed during the side event hosted by the NIHR Global Surgery Unit at the World Health Assembly on 28 May.
