Article Text
Abstract
Objectives Comprehensive reporting of surgical disease burden and outcomes are vital components of resilient health systems but remain under-reported. The primary objective was to identify the Victorian surgical burden of disease necessitating treatment in a hospital or day centre, including a thorough epidemiology of surgical procedures and their respective perioperative mortality rates (POMR).
Design Retrospective population-level observational study.
Setting The study was conducted in Victoria, Australia. Access to data from the Victorian Admitted Episodes Dataset was obtained using the Dr Foster Quality Investigator tool. The study included public and private facilities, including day-case facilities.
Participants From January 2014 to December 2016, all admissions with an International Statistical Classification of Diseases-10 code matched to the Global Health Estimates (GHE) disease categories were included.
Primary and secondary outcome measures Admissions were assigned a primary disease category according to the 23 GHE disease categories. Surgical procedures during hospitalisations were identified using the Australian Refined Diagnosis Related Groups (AR-DRG). POMR were calculated for GHE disease categories and AR-DRG procedures.
Results A total of 4 865 226 admitted episodes were identified over the 3-year period. 1 715 862 (35.3%) of these required a surgical procedure. The mortality rate for those undergoing a procedure was 0.42%, and 1.47% for those without. The top five procedures performed per GHE category were lens procedures (162 835 cases, POMR 0.001%), caesarean delivery (76 032 cases, POMR 0.01%), abortion with operating room procedure (65 451 cases, POMR 0%), hernia procedures (52 499 cases, POMR 0.05%) and other knee procedures (47 181 cases, POMR 0.004%).
Conclusions Conditions requiring surgery were responsible for 35.3% of the hospital admitted disease burden in Victoria, a rate higher than previously published from Sweden, New Zealand and the USA. POMR is comparable to other studies reporting individual procedures and conditions, but has been reported comprehensively across all GHE disease categories for the first time.
- surgery
- epidemiology
- health policy
- public health
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Footnotes
Contributors All authors meet ICMJE requirements for authorship. DW devised the project, DW and TF developed the main conceptual ideas and design; JR and GDG contributed to the design of the project. TF acquired the data. TF, DW and JR performed the analysis and interpretation of data. TF drafted the manuscript and JR, GDG and DW revised it critically. Final approval was provided by TF, JR, GDG and DW.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Ethics approval Ethical approval was granted by the Doctor Foster Clinical Focus Group within the DHHS for Victoria. This focus group was comprised of a committee of senior clinicians from different health services, delegated by DHHS to provide oversignt of the use of DFQI, including providing independent ethical and publication approvat of related research projects.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement A de-identified summary of the data is available for use in Appendix 1, no additional data is available.
Patient consent for publication Not required.