Economic Indicators, Quantity and Quality of Health Care Resources Affecting Post-surgical Mortality

Overview

Journal J Epidemiol Glob Health

Publisher Springer

Date 2024 May 27

PMID 38801492

Authors

Raffaele Merola

Maria Vargas

Affiliations

Soon will be listed here.

Abstract

Objective: to identify correlations between quality and quantity of health care resources, national economic indicators, and postoperative in-hospital mortality as reported in the EUSOS study.

Methods: Different variables were identified from a series of publicly available database. Postoperative in-hospital mortality was identified as reported by EUSOS study. Spearman non-parametric and Coefficients of non-linear regression were calculated.

Results: Quality of health care resources was strongly and negatively correlated to postoperative in-hospital mortality. Quantity of health care resources were negatively and moderately correlated to postoperative in-hospital mortality. National economic indicators were moderately and negatively correlated to postoperative in-hospital mortality. General mortality, as reported by WHO, was positively but very moderately correlated with postoperative in-hospital mortality.

Conclusions: Postoperative in-hospital mortality is strongly determined by quality of health care instead of quantity of health resources and health expenditures. We suggest that improving the quality of health care system might reduce postoperative in-hospital mortality.

Citing Articles

Tracheostomy Practice in the Italian Intensive Care Units: A Point-Prevalence Survey.

Merola R, Vargas M, Sanfilippo F, Vergano M, Mistraletti G, Vetrugno L Medicina (Kaunas). 2025; 61(1.

PMID: 39859070 PMC: 11766958. DOI: 10.3390/medicina61010087.

References

Jacobs J, OBrien S, Pasquali S, Jacobs M, Lacour-Gayet F, Tchervenkov C . Variation in outcomes for risk-stratified pediatric cardiac surgical operations: an analysis of the STS Congenital Heart Surgery Database. Ann Thorac Surg. 2012; 94(2):564-71. PMC: 4006082. DOI: 10.1016/j.athoracsur.2012.01.105. View

Narasimhan V, Brown H, Pablos-Mendez A, Adams O, Dussault G, Elzinga G . Responding to the global human resources crisis. Lancet. 2004; 363(9419):1469-72. DOI: 10.1016/S0140-6736(04)16108-4. View

Hutter M, Rowell K, Devaney L, Sokal S, Warshaw A, Abbott W . Identification of surgical complications and deaths: an assessment of the traditional surgical morbidity and mortality conference compared with the American College of Surgeons-National Surgical Quality Improvement Program. J Am Coll Surg. 2006; 203(5):618-24. DOI: 10.1016/j.jamcollsurg.2006.07.010. View

Cennamo G, Carotenuto A, Montorio D, Petracca M, Moccia M, Melenzane A . Peripapillary Vessel Density as Early Biomarker in Multiple Sclerosis. Front Neurol. 2020; 11:542. PMC: 7311750. DOI: 10.3389/fneur.2020.00542. View

Pearse R, Moreno R, Bauer P, Pelosi P, Metnitz P, Spies C . Mortality after surgery in Europe: a 7 day cohort study. Lancet. 2012; 380(9847):1059-65. PMC: 3493988. DOI: 10.1016/S0140-6736(12)61148-9. View

Bottle A, Middleton S, Kalkman C, Livingston E, Aylin P . Global comparators project: international comparison of hospital outcomes using administrative data. Health Serv Res. 2013; 48(6 Pt 1):2081-100. PMC: 3876394. DOI: 10.1111/1475-6773.12074. View

Musgrove P, Zeramdini R, Carrin G . Basic patterns in national health expenditure. Bull World Health Organ. 2002; 80(2):134-42. PMC: 2567725. View

Hussain S, Mubeen I, Ullah N, Shah S, Khan B, Zahoor M . Modern Diagnostic Imaging Technique Applications and Risk Factors in the Medical Field: A Review. Biomed Res Int. 2022; 2022:5164970. PMC: 9192206. DOI: 10.1155/2022/5164970. View

Jhanji S, Thomas B, Ely A, WATSON D, Hinds C, Pearse R . Mortality and utilisation of critical care resources amongst high-risk surgical patients in a large NHS trust. Anaesthesia. 2008; 63(7):695-700. DOI: 10.1111/j.1365-2044.2008.05560.x. View

10.

Pupelis G, Vanags I . Mortality after surgery in Europe. Lancet. 2013; 381(9864):369. DOI: 10.1016/S0140-6736(13)60159-2. View

11.

Dunn J, Burgess B, Ross N . Income distribution, public services expenditures, and all cause mortality in US States. J Epidemiol Community Health. 2005; 59(9):768-74. PMC: 1733131. DOI: 10.1136/jech.2004.030361. View

12.

De Hert S, Imberger G, Carlisle J, Diemunsch P, Fritsch G, Moppett I . Preoperative evaluation of the adult patient undergoing non-cardiac surgery: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2011; 28(10):684-722. DOI: 10.1097/EJA.0b013e3283499e3b. View

13.

Sposato L, Saposnik G . Gross domestic product and health expenditure associated with incidence, 30-day fatality, and age at stroke onset: a systematic review. Stroke. 2011; 43(1):170-7. DOI: 10.1161/STROKEAHA.111.632158. View

14.

Chin M, Muramatsu N . What is the quality of quality of medical care measures? Rashomon-like relativism and real-world applications. Perspect Biol Med. 2003; 46(1):5-20; discussion 21-3. DOI: 10.1353/pbm.2003.0002. View

15.

Wunsch H, Angus D, Harrison D, Collange O, Fowler R, Hoste E . Variation in critical care services across North America and Western Europe. Crit Care Med. 2008; 36(10):2787-93, e1-9. DOI: 10.1097/CCM.0b013e318186aec8. View

16.

Braithwaite J, Hibbert P, Blakely B, Plumb J, Hannaford N, Long J . Health system frameworks and performance indicators in eight countries: A comparative international analysis. SAGE Open Med. 2017; 5:2050312116686516. PMC: 5308535. DOI: 10.1177/2050312116686516. View

17.

Rhodes A, Ferdinande P, Flaatten H, Guidet B, Metnitz P, Moreno R . The variability of critical care bed numbers in Europe. Intensive Care Med. 2012; 38(10):1647-53. DOI: 10.1007/s00134-012-2627-8. View

18.

Lanzillo R, Cennamo G, Moccia M, Criscuolo C, Carotenuto A, Frattaruolo N . Retinal vascular density in multiple sclerosis: a 1-year follow-up. Eur J Neurol. 2018; 26(1):198-201. DOI: 10.1111/ene.13770. View

19.

Fuchs V . The gross domestic product and health care spending. N Engl J Med. 2013; 369(2):107-9. DOI: 10.1056/NEJMp1305298. View

20.

Anand S, Barnighausen T . Human resources and health outcomes: cross-country econometric study. Lancet. 2004; 364(9445):1603-9. DOI: 10.1016/S0140-6736(04)17313-3. View