Frequency of surgery and hospital admissions for communicable diseases in a high-and middle-income setting

Abstract

Background: In high-income countries, non-communicable diseases drive the demand for surgical healthcare. Middle-income countries face a double disease burden, of both communicable and non-communicable disease. The aim of this study was to describe the role of surgery for the in-hospital care of infectious conditions in the high-income country Sweden and the middle-income country South Africa. Methods: A retrospective cohort study was performed of 1⋅4 million infectious disease admissions. The study populations were the entire population of Sweden, and a cohort of 3⋅5 million South Africans with private healthcare insurance, during a 7-year interval. The outcome measures were frequency of surgical procedures across a spectrum of diseases, and sex and age during the medical care event. Conclusion: The study suggests that surgical care is required to manage patients with communicable diseases, even in high-income settings with efficient prevention and functional primary care. These results further stress the importance of scaling up functional surgical health systems in low-and middle-income countries, where the disease burden is distinguished by infectious disease