Timely Access to Essential Surgery, Surgical Workforce, and Surgical Volume: Global Surgery Indicators in Mexico

Rafael H. Pérez-Soto; Alicia Maybi Trolle-Silva; Gabriela Alejandra Buerba-Romero Valdés; Germán Esteban Sánchez-Morales; David Velázquez-Fernández; Antonio Ramos-De la Medina; Miguel F. Herrera

doi:10.9745/GHSP-D-21-00745

Key Findings

In addition to geographical access to surgical care, other factors, including surgical workforce and surgical volume, affect access to essential surgical services.
When considering Mexico’s fragmented public health system, an estimated 81.7% of the population have timely access to surgical care, but municipalities where population access was less than 20% were scattered throughout the country.
Surgical workforce increase has been proportional to the Mexican population growth during the last 5 years, indicating no improvement in this area.

Key Implication

Policy changes are necessary to improve equitable and timely access to essential surgery services across the Mexican population.

ABSTRACT

Introduction:

The Lancet Commission on Global Surgery seeks to improve surgical care outcomes and equity for the world population through 6 indicators outlined in its 2030 Global Surgery Report. Our study aimed to estimate the percentage of the Mexican population with access to surgical care within the 2-hour distance range (indicator 1), the surgical workforce density (indicator 2), and the number of surgical procedures performed per 100,000 inhabitants (indicator 3) during the year 2020. Knowing these indicators can help to design and implement policies to increase surgical care access coverage and equity in our country.

Methods:

Data related to population distribution, local referral hospitals, and surgical volume were obtained from the 2020 Mexican National Census. Information relating to hospital characteristics and surgical specialists was collected from the Secretariat of Health’s public records. We calculated travel time between health care facilities and municipalities using the TrueWay Matrix API and R Studio.

Results:

Taking into consideration the health care system affiliation, the proportion of the Mexican population with timely access to essential surgery was 81.7%, with 29.3 specialists per 100,000 inhabitants and 726.9 annual procedures performed per 100,000 inhabitants. We identified clusters of municipalities where a low proportion of the population has timely access to essential surgery.

Conclusion:

These findings illustrate that changes in Mexican policy are required to facilitate more equitable and timely access to essential surgical care among the population.

Received: August 23, 2022.
Accepted: January 2, 2023.
Published: February 28, 2023.

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https://doi.org/10.9745/GHSP-D-21-00745

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