Caseload distribution of general surgeons in regional Australia: is there a role for a rural surgery sub‐specialization?

Bappayya, Shaneel; Chen, Fiona; Alderuccio, Megan; Schwalb, Heinrich

doi:10.1111/ans.14680

Cited by 19 publications

(27 citation statements)

References 12 publications

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“…The majority of rural surgical procedures performed in this study were endoscopic procedures (54%), higher than published figures from Victoria 27–35.9% 5–7 . In Australia, Gastroenterologists share the majority of the endoscopic caseload.…”

Section: Discussioncontrasting

confidence: 52%

“…However, there is limited literature describing general surgical caseloads and casemix in regional and rural Australia. Existing studies were insightful but limited by the accuracy of logbooks kept by surgeons, small sample size, and reviewing only subsets of surgeons working in a single center 5–7 . In this study we aim to analyse the caseloads and casemix of four rural general surgical departments in South Australia over a 6 year period.…”

Section: Introductionmentioning

confidence: 99%

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Extended scope of practice needed for Australian rural general surgeons: a review of South Australia's rural general surgical caseload and case mix

Liu

Lei

Reid

et al. 2022

ANZ Journal of Surgery

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Background There is a shortage of surgeons caring for the 33% of Australians residing in rural and regional areas. In order to help appreciate what rural general surgery entails and optimize training for aspiring rural surgeons, the aim of this study was to analyse the general surgical departments' procedural caseload and casemix in four rural South Australian hospitals. Methods This is a retrospective multi‐centre study involving four rural surgical centres in South Australia (Mt Gambier, Whyalla, Port Augusta, and Port Lincoln). Surgical procedures performed from 2014–2020 were extracted from departmental audits. To identify trends of surgical procedure over time, the data was divided into three time periods (Period 1: February 2014–December 2015, Period 2: January 2016–December 2017, Period 3: January 2018–March 2020). Results A total of 44 191 surgical procedures were performed, 70.2% being day procedures. 54% were endoscopic procedures, 46% were operative procedures. 60.6% of the operative procedures were general surgery procedures. 28.5% were general surgery‐based subspecialty (colorectal, hepato‐pancreato‐biliary, upper gastrointestinal, and breast). 10.9% were non‐general surgery‐based subspecialty (urology, plastics, vascular, orthopaedics, head and neck, and obstetrics and gynaecology). There were no statistically significant fluctuations in procedure caseload in all aspects (endoscopic and operative procedures) over the three time periods. Conclusion The majority of a rural Australian general surgeon's procedures are endoscopic. Operative procedures are mainly general surgery based. It may be beneficial to equip aspiring rural general surgeons to manage basic non‐general surgery procedures (urological, vascular, and orthopaedic).

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Section: Discussioncontrasting

confidence: 52%

Section: Introductionmentioning

confidence: 99%

Extended scope of practice needed for Australian rural general surgeons: a review of South Australia's rural general surgical caseload and case mix

Liu

Lei

Reid

et al. 2022

ANZ Journal of Surgery

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“…Significant variation with regard to meeting key performance indicators for high‐quality colonoscopy has been reported 4 . Diagnostic and therapeutic endoscopies of the colon represent a major portion of the rural general surgical workload 11 . This study has addressed the question whether rural surgeons in Australia meet KPIs of high‐quality colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

Quality of rural colonoscopy outperforms key performance indicators in a multi‐centre prospective clinical study

Watson

Maddern

et al. 2022

ANZ Journal of Surgery

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Background High‐quality colonoscopy is vital for the detection and removal of adenomatous polyps and early diagnosis of colorectal cancer. The aim of this study was to prospectively assess the quality and safety of colonoscopies performed in the non‐metropolitan setting. Key performance indicators measured include completion, polypectomy and adenoma/serrated polyp detection rates, rate of adequate bowel preparation, withdrawal time and complications. Methods Prospective data collection for all colonoscopies performed over a one‐year period in seven non‐metropolitan South Australian hospitals. Two general surgeons and twelve registrars working in rural South Australian hospitals (Mount Gambier, Millicent, Naracoorte, Port Lincoln, Port Augusta, Whyalla and Berri) contributed to this study. Results In total 3497 colonoscopies were analysed. Complete colonoscopy was achieved in 96.1%. The adenoma detection and serrated polyp detection rates were 25.6% and 5.4% respectively. Cancer was detected in 71 patients (2%). Colonic perforation occurred in five patients (0.1%). There was no procedure‐related mortality. Conclusions Colonoscopy performed in the non‐metropolitan Australian setting outperforms key performance indicators set by national institutions. This is the first Australian prospective multi‐centre study investigating the quality and safety of endoscopic procedures.

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“…14,15 Endoscopic procedures are a significant part of rural general surgeons' casemix, with studies reporting endoscopies to be up to 36% of all operations/procedures carried out. 16 The aim of this prospective study was to establish the quality of a rural colonoscopy service.…”

Section: Introductionmentioning

confidence: 99%

Quality of rural colonoscopy—A prospective single‐centre pilot study

Watson

Maddern

McCullough³

et al. 2021

Australian J Rural Health

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Caseload distribution of general surgeons in regional Australia: is there a role for a rural surgery sub‐specialization?

Abstract: This study adds weight to the value of a broad skill set in provision of surgical services in a rural setting.

Cited by 19 publications

References 12 publications

Extended scope of practice needed for Australian rural general surgeons: a review of South Australia's rural general surgical caseload and case mix

Extended scope of practice needed for Australian rural general surgeons: a review of South Australia's rural general surgical caseload and case mix

Quality of rural colonoscopy outperforms key performance indicators in a multi‐centre prospective clinical study

Quality of rural colonoscopy—A prospective single‐centre pilot study

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