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Original Article
Open Access

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 and Miguel F. Herrera
Global Health: Science and Practice February 2023, 11(1):e2100745; https://doi.org/10.9745/GHSP-D-21-00745
Rafael H. Pérez-Soto
aEndocrine and Advanced Laparoscopic Surgery Service, Department of Surgery, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
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  • For correspondence: rafael.perez.dr{at}gmail.com
Alicia Maybi Trolle-Silva
bDepartment of Anatomical Pathology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
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Gabriela Alejandra Buerba-Romero Valdés
cGeneral Surgery Service, Department of Surgery, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
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Germán Esteban Sánchez-Morales
cGeneral Surgery Service, Department of Surgery, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
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David Velázquez-Fernández
aEndocrine and Advanced Laparoscopic Surgery Service, Department of Surgery, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
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Antonio Ramos-De la Medina
dDepartment of Surgery, Hospital Español de Veracruz, Veracruz, Mexico.
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Miguel F. Herrera
aEndocrine and Advanced Laparoscopic Surgery Service, Department of Surgery, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico City, Mexico.
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Figures & Tables

Figures

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  • FIGURE 1
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    FIGURE 1

    Geographic Distribution of Health Facilities in Mexico in 2020

    Abbreviations: IMSS, Instituto Mexicano del Seguro Social; ISSSTE, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado; PEMEX, Petróleos Mexicanos; SEDENA, Secretaría de la Defensa Nacional; SEMAR, Secretaría de Marina; SSA, Secretaría de Salud.

  • FIGURE 2
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    FIGURE 2

    Proportion of Population With Timely Access to Surgical Care Among Mexican States in 2020

  • FIGURE 3
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    FIGURE 3

    Proportion of Population With Timely Access to Surgical Care Among Mexican Municipalities in 2020

Tables

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    TABLE 1.

    Lancet Commission on Global Surgery 2030 Indicators and Goals5

    IndicatorDescription2030 Goals
    Access to timely essential surgeryProportion of the population that can access, within 2 hours, a facility that can do cesarean delivery, laparotomy, and treatment of open fractureAt least 80% coverage per country
    Specialist surgical workforce densityNumber of specialist surgical, anesthetic, and obstetric physicians who are working, per 100,000 population100% of countries with at least 20 surgical, anesthetic, and obstetric physicians per 100,000 population
    Surgical volumeProcedures done in an operating theater, per 100,000 population per year100% of countries with a minimum 5,000 procedures per 100,000 population
    Perioperative mortalityAll-cause death rate before discharge in patients who have undergone a procedure in an operating theater, divided by the total number of procedures, presented as a percentage100% countries tracking perioperative mortality
    Protection against impoverishing expenditureProportion of households protected against impoverishment from direct out-of-pocket payments for surgical and anesthesia care100% protection against impoverishment from out-of-pocket payments for surgical and anesthesia care
    Protection against catastrophic expenditureProportion of households protected against catastrophic expenditure from direct out-of-pocket payment for surgical and anesthesia care100% protection against catastrophic expenditure from out-of-pocket payments for surgical and anesthesia care
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    TABLE 2.

    Demographic Data, Access to Timely Essential Surgery, Surgical Workforce Density, and Surgical Volume for the 32 Mexican States in 2020

    StatePopulation2020, No.Localities,No.COVID-19Cases per100,000PersonsPopulation WithAccess to SurgicalCare <2 Hours,No. (%)SurgicalSpecialistWorkforce, No.(SurgicalSpecialist per100,000Inhabitants)SurgicalProcedures,No.SurgicalProceduresper 100,000Persons, No.
    Northwest
     Baja California3,769,0205,545993.203,383,533 (89.77)a4,097 (108.70)15,751417.90
     Baja California Sur798,4472,5432,275.41735,181 (92.07)a1,598 (200.13)7,450933.06
     Chihuahua3,741,86912,1861,065.403,182,528 (85.05)a4,897 (130.87)23,978640.80
     Durango1,832,6505,8901,439.991,196,336 (65.27)2,751 (150.11)16,481899.29
     Sinaloa3,026,9435,495913.852,683,966 (88.66)a4,691 (154.97)18,981627.06
     Sonora2,944,8407,3001,925.402,717,896 (92.29)a4,981 (169.14)21,556731.99
    Northeast
     Coahuila de Zaragoza3,146,7714,0341,684.422,770,363 (88.03)a4,599 (146.14)11,729372.73
     Nuevo León5,784,4424,8221,479.154,692,210 (81.11)a6,402 (110.67)20,808359.72
     Tamaulipas3,527,7356,5661,195.272,817,000 (79.85)5,562 (157.66)24,309689.08
    West
     Colima731,3911,1261,097.22689,356 94.25)a1,459 (199.48)6,225851.11
     Jalisco8,348,15110,348658.256,379,923 (76.42)9,927 (118.9153,459640.36
     Michoacán de Ocampo4,748,8468,644726.284,222,771 (88.92)a5,626 (118.47)33,231699.77
     Nayarit1,235,4562,850648.821,078,681 (87.31)a2,090 (169.16)7,285589.66
    East
     Hidalgo3,082,8414,690813.012,544,173 (82.52)a3,911 (126.86)24,688800.81
     Puebla6,583,2786,568770.555,811,371 (88.27)a7,271 (110.44)44,481675.66
     Tlaxcala1,342,9771,175883.331,131,686 (84.26)a1,906 (141.92)12,119902.39
     Veracruz de Ignacio de la Llave8,062,57919,845556.456,717,601 (83.31)a10,772 (133.60)59,491737.86
    North Center
     Aguascalientes1,425,6072,0221,262.541,285,601 (90.17)a2,354 (165.12)18,5731302.81
     Guanajuato6,166,9348,8091,398.875,417,006 (87.83)a7,649 (124.03)92,2171495.34
     Querétaro2,368,4672,1921,449.671,722,168 (72.71)2,944 (124.29)20,642871.53
     San Luis Potosí2,822,2556,5541,492.812,277,295 (80.69)a3,185 (112.85)18,909669.99
     Zacatecas1,622,1384,498,1,324.601,070,288 (65.98)2,464 (151.89)23,3781441.18
    South Center
     Ciudad de México9,209,9446343,933.527,354,274 (79.85)25,572 (277.65)77,930846.15
     Estado de México16,992,4184,894952.2412,256,308 (72.12)17,689 (104.09)93,326549.22
     Morelos1,971,5201,578580.111,337,400 (67.83)2,814 (142.73)13,719695.85
    Southwest
     Chiapas5,543,82821,157153.554,310,336 (77.75)5,969 (107.66)29,501532.14
     Guerrero3,540,6856,769754.573,057,466 (86.35)a5,938 (167.70)32,290911.97
     Oaxaca4,132,14810,723719.672,973,945 (71.97)5,333 (129.06)26,082631.19
    Southeast
     Campeche928,3632,762811.75761,749 (82.05)a1,879 (202.39)7,117766.61
     Quintana Roo1,857,9852,207867.33991,689 (53.37)2,341 (125.99)13,138707.11
     Tabasco2,402,5982,4721,861.771,898,068 (79.00)4,639 (193.08)28,7661197.28
     Yucatán2,320,8982,4341,156.101,973,427 (85.02)a3,752 (161.66)18,150782.02
    Total126,014,024189,4321,208.49102,967,672 (81.71)a36,973 (29.34)916,120726.99
    • ↵a Goal indicator accomplished.

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Global Health: Science and Practice: 11 (1)
Global Health: Science and Practice
Vol. 11, No. 1
February 28, 2023
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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
Global Health: Science and Practice Feb 2023, 11 (1) e2100745; DOI: 10.9745/GHSP-D-21-00745

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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
Global Health: Science and Practice Feb 2023, 11 (1) e2100745; DOI: 10.9745/GHSP-D-21-00745
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