Trends in the delivery of elective general paediatric surgery
| Autor: | Tiboni Sg, Stewart Rj |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Databases Factual Workload Hospitals General State Medicine 03 medical and health sciences 0302 clinical medicine 0502 economics and business medicine Hospital Planning Humans Child Surgeons Paediatric surgery business.industry General surgery 05 social sciences Infant Newborn Infant General Medicine Hospitals Pediatric England Elective Surgical Procedures 030220 oncology & carcinogenesis Child Preschool Workforce planning Surgery Female business Surgery Department Hospital Paediatric Surgery 050203 business & management Specialization |
| Zdroj: | Ann R Coll Surg Engl |
| ISSN: | 1478-7083 |
| Popis: | Introduction There has been regular dialogue regarding the importance of developing clinical networks to compensate for the steady decline in general paediatric surgery performed by adult surgeons. Despite this dialogue, there are no contemporary published data to quantify the issue. This report documents patterns in delivery of general paediatric surgery in England and shows what is being performed where and by whom. Materials and methods Using the Surgical Workload Outcome Database, we compared hospital-level data between 2009 and 2017. Inclusion criteria were children under 18 years admitted to NHS hospitals in England for elective general paediatric surgery. Data were analysed with an online statistical package performing paired t-tests. Results There was no real change in the overall number of elective general paediatric surgical marker cases, but the type mix has changed. The number of marker cases performed by adult surgeons fell by 34% (4699 vs 3090 p < 0.05). The number of marker cases performed by specialist paediatric surgeons increased by 21% (8184 vs 9862 p < 0.05). This increase in workload occurred in both tertiary (21% increase) and peripheral (18% increase) centres. When analysing data by operation type it was apparent that 78% of the increased workload was attributable to an increase in orchidopexy rate. Conclusion Best practice is to treat children close to home by staff with the right skills. This study shows significant shifts in the general paediatric surgical workload. It is important to monitor these trends for successful succession planning as well as configuration of services. |
| Databáze: | OpenAIRE |
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