Cardiac Surgery in Low- and Middle-Income Countries: A State-of-the-Art Review

Vervoort, Dominique; Swain, JaBaris D.; Pezzella, A. Thomas; Kpodonu, Jacques

doi:10.1016/j.athoracsur.2020.05.181

Cited by 109 publications

(120 citation statements)

References 51 publications

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“…Data-driven efforts, such as the International Quality Improvement Collaborative, 3 can further emphasize continuous quality improvement along with comprehensive monitoring and evaluation of surgical volume, patient populations, outcomes, and even financial metrics. Examples from centers in India (eg, Narayana Health) and China (eg, Shanghai Children's Medical Center), which provide some of the highest annual per-center cardiac surgery volumes at some of the lowest costs anywhere in the world, 5 are ones to follow, illustrating the power of bridging the public-private divide.…”

Section: Reply: Bridging the Public-private Divide Reply To The Editormentioning

confidence: 99%

Reply from author: Bridging the public–private divide

Vervoort

2022

The Journal of Thoracic and Cardiovascular Surgery

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Section: Reply: Bridging the Public-private Divide Reply To The Editormentioning

confidence: 99%

Reply from author: Bridging the public–private divide

Vervoort

2022

The Journal of Thoracic and Cardiovascular Surgery

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“…Such models have been leveraged by, for example, Narayana Hrudayalaya Heart Hospital (NHHH) in Bangalore, India. 2 NHHH is an 800-bed hospital that accounts for 12% of India's cardiac surgeries. Through the standardization of processes, reliance on core competencies (such that employees spend time on performing tasks only at their skill level), and using economies of scale, the hospital is able to bring down costs and maximize volume.…”

Section: Financial Needsmentioning

confidence: 99%

Health System Needs to Establish Cardiac Surgery Centers

Vervoort

Premkumar

Ghandour

et al. 2021

Thorac Cardiovasc Surg

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Cardiovascular diseases are the leading cause of mortality worldwide, responsible for nearly 18 million deaths each year. More than 80% of these take place in low- and middle-income countries (LMICs), where access to cardiac surgical services is scarce. Approximately 93% of the LMIC population, or six billion people worldwide, are estimated to lack access to safe, timely, and affordable cardiac surgical care as a result of workforce, infrastructure, financial, and quality barriers. Various models have been proposed and attempted to establish cardiac surgery centers in LMICs; however, only some have been successful in achieving sustainable local services. Here, we describe the workforce, infrastructure, financial, and political needs and considerations from a health systems perspective to establish a cardiac surgery center.

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“…Surgical care has become increasingly recognized as an essential part of universal health coverage, yet access to safe, timely, and affordable cardiac surgical care remains a luxury for over three‐quarter of the world population 1 . Low‐ and middle‐income countries (LMICs) are disproportionately affected as a result of limited workforce, infrastructure, and sustainable health financing mechanisms.…”

Section: Introductionmentioning

confidence: 99%

“…Low‐ and middle‐income countries (LMICs) are disproportionately affected as a result of limited workforce, infrastructure, and sustainable health financing mechanisms. Where high‐income countries have 7.15 cardiac surgeons per million population, low‐income countries only have 0.04 per million 1 . Despite the onset of various local and visiting capacity‐building programs, resources remain limited to accelerate progress.…”

Section: Introductionmentioning

confidence: 99%