Neurosurgery in Ukraine: comparison with other countries of the world
Keywords:density of neurosurgical beds, density of neurosurgeons, neurosurgical operations per population, number of operations done by one neurosurgeon per year, average length of stay for neurosurgical patients, bed occupancy
The object is to determine the state and performance indicators of the bed density and workforce of the neurosurgical network of Ukraine. To conduct a comparative analysis of the data obtained with the data from other countries.
Materials and methods. The work is based on the analysis of the results of a continuous study of the bed density, workforce, and medical work of neurosurgical departments of Ukraine in 2014-2019. The data on neurosurgical beds, workforce, and their work in other countries are taken from scientific articles or open Internet sources.
The study did not include departments and physicians located on the non-controlled territory. When calculating the indicators, the population of the Crimea, Sevastopol, DPR, and LPR was not taken into account.
Statistical data processing was performed using the analysis of dynamic series, using the median, arithmetic mean, weighted average, and quartiles. Microsoft Excel was used for calculations.
Results. The density of neurosurgical beds in 2019 was 81 per 1 million population. This is a high level of density compared to Sweden, the Netherlands, Norway, and the UK (20-30), but lower than in the Russian Federation (90), the Czech Republic, Germany, and Greece (100).
The density of neurosurgeons per 1 million population and the ratio of neurosurgeons to the total population in 2019 was 16.8 / 1 : 59,502, which corresponds to the indicator in the Russian Federation — 16.8 / 1 : 59,524, significantly lower than in Japan — 58.95 / 1 : 16962] and higher than in the USA — 15.2 / 1 : 65,580. When comparing the indicators of 2016, it was revealed that the density of neurosurgeons per 1 million population in Ukraine is higher than the average in Europe — 17.5 against 11.76.
In 2019, 1,127 neurosurgical patients were operated in Ukraine per 1 million population, which is lower than the average level of neurosurgical care for the European population (1,642).
The average stay of a patient in a bed in 2019 was 10.5 days, and the bed occupancy was 81 % (297 days of work per year), which meets the international standard for bed occupancy (80-85 % / 292-310 days).
Conclusions. The regions of Ukraine differ in the density of neurosurgical beds and neurosurgeons, but the population of the country as a whole is provided with them at the level of European standards.
The performance of the bed density and workforce of the neurosurgical network of Ukraine corresponds to this in several European countries, but, despite the positive dynamics, it is still less than the average European indicator and does not cover the annual demand of the country.
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