Peter Lee, Scott Regenbogen, Atul A. Gawande
Caritas St. Elizabeth’s Medical Center; Boston, MA
PURPOSE OF STUDY
Surgery is a basic but expensive and risky component of healthcare. However, the amount of surgery that individuals experience in modern healthcare is unknown. A quantification of the volume of invasive procedures a person would experience in a lifetime under current medical practice could illuminate the extent of our dependence on such techniques, and provide a benchmark for evaluating trends.
The average lifetime volume of surgery was estimated by summing per capita rates of surgical procedures for each year of age between 0 and 84. Surgical data were obtained from the 2002 State Inpatient Database (SID) and State Ambulatory Surgery Database (SASD) for Colorado, Florida, and New Jersey. Surgical procedures were categorized according to Clinical Classification Software grouping to identify the greatest contributors to surgical volume for men and women.
SUMMARY OF RESULTS:
As medicine was practiced in three states in 2002, Americans undergo an average of 9.2 surgical procedures (3.4 inpatient operations, 2.6 outpatient operations, and 3.2 non-operating room invasive procedures) per lifetime. The most common operations are coronary angioplasty, wound debridement, and groin hernia repair for men, and cesarean section, cholecystectomy, and lens and cataract surgery for women. The per capita rate of surgery continues to increase through age 75, peaking at 0.16 operations per person per year.
Under modern practices, Americans experience multiple invasive interventions across their lifespan, with increasing frequency as they age. Considering the significant risks of surgery, initiatives to improve the safety and outcomes of surgery would have a broad impact on public health.