Neurosurgical service in Ukraine in 2013. Optimization of neurosurgical resources

Abstract

Objective: To assess the state of the neurosurgical service, the provision of neurosurgical care to the population of Ukraine in 2013 compared to 2012, and to explore the possibilities for its optimization.Materials. The results of a comprehensive study of clinical work, the bed capacity and staff levels of the neurosurgical departments of Ukraine in 2012 and 2013 were analyzed. Results. As of 01.01.2014, neurosurgical care in Ukraine was provided in a total of 134 units with a 3,899 neurosurgical bed capacity. In 2013, neurosurgical care was provided by 833 neurosurgeons, which is twice as many as in 2012 (1.83 neurosurgeons per 100,000 population). The number of patients per 1 million population treated in 2013 increased by 4.0% compared to 2012, and amounted to 2,350; the number of patients operated per 1 million population was 1,031 (3.5 growth against 2012). Surgical activity slightly decreased from 44.1% in 2012 to 43.9% in 2013 Overall mortality and postoperative mortality show the same tendency: from 2.9 to 2.8% and from 4.4 to 4.3 % respectivelyConclusions. With the high neurosurgical capacity in Ukraine, neurosurgical beds are largely underutilized. Positive dynamics in the performance of neurosurgical departments of Ukraine has been recorded, although there is an obvious lag compared to similar performance indicators in European countries. Neurosurgical bed and neurosurgical staff numbers are subject to audit, however, it is deemed advisable to reduce these numbers. It would be rational to convert low performance neurosurgical units into neurosurgical and neurological vascular care ones.