Current status of subspecialization in pediatric surgery: A focus on fetal surgery

Lopyan, Natalie M.; Perrone, Erin E.; Gadepalli, Samir K.; Raval, Mehul V.; Tsao, Kuo Jen; Rich, Barrie S.

doi:10.1016/j.jpedsurg.2021.05.008

Cited by 4 publications

(3 citation statements)

References 9 publications

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Section: Discussionmentioning

confidence: 99%

“…36 The development and growth of pediatric urology as a pediatric surgery subspecialty serve as a prime example of the spontaneous trend toward subspecialization, as does the evolution of fetal surgery. 37 Arguments against the regionalization of healthcare include the potential for social dislocation for families, the risk of increased incidental expenses, and the likelihood of pediatric surgeons losing their expertise and income. [21][22][23] However, experiences such as the center for anorectal malformations or the hepatobiliary surgery in Cincinnati demonstrate that concentrating the treatment of certain complex issues in resource-rich children's environments may be better than approaching these problems as a yearly event at a general county hospital by a general pediatric surgeon.…”

Section: Open Accessmentioning

confidence: 99%

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Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil

Bustorff‐Silva

Miranda

Rosendo

et al. 2023

World Jnl Ped Surgery

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ObjectiveThe purpose of this study is to examine the regional distribution of the pediatric surgery workforce and the expected local demand for pediatric surgical procedures in Brazil.MethodsWe collected data on the pediatric surgical workforce, surgical volume, Gross Domestic Product per capita, and mortality for gastrointestinal tract malformations (MGITM) across the different regions of Brazil for 2019.ResultsData from the Federal Medical Council reported 1515 pediatric surgery registries in Brazil, corresponding to 1414 pediatric surgeons (some pediatric surgeons are registered in more than one state), or 2.4 pediatric surgeons per 100 000 children 14 years of age and younger. There were 828 men and 586 women. The mean age was 51.5±12.8 years, and the mean time from graduation was 3.4±5.7 years. There is a higher concentration of pediatric surgeons in the wealthier Central-West, South, and Southeast regions. Individual surgical volume ranged from 88 to 245 operations/year (average 146 operations/year) depending on the region. Of these, only nine (6.1%) were high-complexity (including neonatal) operations. MGITM tended to be higher in the poorer North and Northeast regions than in other regions of Brazil.ConclusionsOur findings suggest significant disparities in the surgical workforce and workload across Brazil related to socioeconomic status. Regions with an increased surgical workforce were associated with lower MGITM. The average number of complex operations performed annually by each pediatric surgeon was considerably low. Strategic investment and well-defined health policies are imperative to enhance the quality of surgical care in the different regions of Brazil.Level of evidenceRetrospective review; level IV.

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Section: Discussionmentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil

Bustorff‐Silva

Miranda

Rosendo

et al. 2023

World Jnl Ped Surgery

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“…It is noteworthy that there is already an internal spontaneous “regionalization” within most pediatric surgery groups around the world, with some surgeons performing or supervising specific complex operations more often than others 31 . The development and growth of Pediatric Urology as a Pediatric Surgery subspecialty is probably one of the best examples of the spontaneous trend for subspecializacion, as is the evolution of Fetal Surgery 32 .…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of The Regional Distribution of Pediatric Surgery Workforce and Surgical Load in Brazil

Bustorff‐Silva¹,

Miranda²,

Rosendo³

et al. 2022

Preprint

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AimThe purpose of this study is to present data on the regional distribution of the pediatric surgical workforce and the expected local demand of pediatric operations in Brazil.MethodsWe collected data on the pediatric surgical workforce, surgical workload, GDP/capita and mortality for gastrointestinal tract malformations (MGITM) across the different regions of Brazil for 2019.FindingsData from CFM reported the existence of 1515 pediatric surgery registries in Brazil, corresponding to 1414 individual pediatric surgeons (some pediatric surgeons are registered in more than one State), or 2.4 pediatric surgeons per 100.000 children< 14 years. There were 828 male and 586 female with a M/F ratio of 1.14:1. Mean age was 51.5±12.8 years and mean time from graduation was 3,4±5,7years. Regional distribution showed a higher concentration of pediatric surgeons on the wealthier Central-West, South and Southeast regions. Individual workload ranged from 88 to 245 operations/year (average 146 operations/year) depending on the region. Only 9 (6.1%) of these were high complexity (including neonatal) operations. MGITM tended to be higher on the poorer North and Northeast regions of BrazilConclusionsWe found wide disparities in the surgical workforce and workload across Brazil, related to socioeconomic status. Areas of increased surgical workforce were associated with lower MGITM. The average number of complex operations performed yearly by the individual pediatric surgeon was considerably low. Strategic investment and definition of health policies may be needed to improve the quality of care in the different regions of Brazil.Level of EvidenceRetrospective review. Level III

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The Respect Due and Denied to Those Who Lack Speech

Bellieni

2022

A New Holistic-Evolutive Approach to Pediatric Palliative Care

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Current status of subspecialization in pediatric surgery: A focus on fetal surgery

Cited by 4 publications

References 9 publications

Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil

Evaluation of the regional distribution of the pediatric surgery workforce and surgical load in Brazil

An Evaluation of The Regional Distribution of Pediatric Surgery Workforce and Surgical Load in Brazil

The Respect Due and Denied to Those Who Lack Speech

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