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Baticulon RE, Lucena LLN, Gimenez MLA, Sabalza MN, Soriano JA. The Neurosurgical Workforce of the Philippines. Neurosurgery 2024; 94:202-211. [PMID: 37931081 DOI: 10.1227/neu.0000000000002630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/23/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND AND OBJECTIVES No study has comprehensively examined the delivery of neurosurgical care in the Philippines, a lower-middle-income country in Southeast Asia with a total population of 109 million. We aimed to quantify the workforce, map the distribution, and characterize the clinical practice of neurosurgeons across the 17 regions and 81 provinces of the Philippines. METHODS An online survey was sent to all fellows of the Academy of Filipino Neurosurgeons and all graduates of neurosurgical training programs in the country. Neurosurgeons who have been in active clinical practice for at least 1 year were eligible to participate. A database of Filipino neurosurgeons was generated through personal communications, correspondence with neurosurgery departments, and accessing publicly available information. The top neurosurgical procedures were identified to estimate the overall volume of neurosurgical disease. RESULTS There are 174 neurosurgeons practicing in the Philippines or approximately one neurosurgeon for every 600 000 people. In 9 provinces, neurosurgeons were only available part-time, and 35 provinces had no neurosurgeons at all, equivalent to an underserved population of 24 million people. Among 99 survey respondents, the median numbers of neurosurgical consults and operations every month were 30 (IQR:35) and 8 (IQR:8), respectively. The top neurosurgical procedures were burr holes/craniotomy for traumatic brain injury, craniotomy for stroke, and biopsy/resection of brain tumors. There are an estimated 93 498 cases requiring essential neurosurgery every year. CONCLUSION Although positive trends have been observed in the number, distribution, and composition of neurosurgeons in the Philippines, there remains a large workforce deficit that needs to be addressed to provide timely, quality, and affordable neurosurgical care to the entire population.
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Affiliation(s)
- Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines Manila, Manila , Philippines
- Department of Anatomy, College of Medicine, University of the Philippines Manila, Manila , Philippines
| | - Lynne Lourdes N Lucena
- Neurosurgery Section, Department of Surgery, Bicol Regional Hospital and Medical Center, Legazpi City , Philippines
| | | | - Michael N Sabalza
- Section of Neurosurgery, Department of Neurosciences, Makati Medical Center, Makati City , Philippines
| | - James A Soriano
- Department of Neurosurgery, Davao Doctors Hospital, Davao City , Philippines
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2
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Vista FES, Alibin MPA, Arevalo MPTN, Gaerlan FJM. Emergency medicine research in the Philippines: A scoping review. J Am Coll Emerg Physicians Open 2023; 4:e13008. [PMID: 37455807 PMCID: PMC10349192 DOI: 10.1002/emp2.13008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/19/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023] Open
Abstract
Objectives In this review, we aim to synthesize the current emergency medicine literature in the Philippines in order to determine the depth of research available in the country while delineating the gaps, helping to provide focus to future research in the field. Methods A literature review was done using 4 databases to identify emergency medicine studies in the Philippines. To explore the research trends among eligible studies, data on study type, countries, and institutions involved as well as study themes were collected and described. Results A total of 845 studies were screened, and 43 were included in this review. Results show that only 25% of emergency medicine studies were published before 2015. Most studies were observational (37.2%) or descriptive (37.2%) in nature with the University of the Philippines/Philippine General Hospital being the most common contributing institution (17.4%). Metro Manila was the most common study site with more than half of studies conducted in the area. Lastly, among the variety of study disciplines, disaster medicine was the most frequent topic comprising 30.2% of studies reviewed. Conclusions Compared to the global scene, Philippine emergency medicine research still has a long way to go. This study was able to provide a landscape of the current literature and highlight the study trends. Further, the findings here emphasize the need to expand the scope of emergency medicine studies in the country as it is still a young and growing field with studies tending to cluster around just a small number of institutions and regions.
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Affiliation(s)
| | | | | | - Faith Joan M. Gaerlan
- College of MedicineUniversity of the Philippines ManilaManilaPhilippines
- Department of Emergency MedicinePhilippine General HospitalManilaPhilippines
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Rehman AU, Ahmed A, Zaheer Z, Ahmed B, Lucke-Wold B. International Neurosurgery: The Role for Collaboration. Int J Med Pharm Res 2023; 4:15-24. [PMID: 36654909 PMCID: PMC9845046 DOI: 10.5281/zenodo.7500584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The global death toll from lack of access to basic surgical care is three times as much as for tuberculosis, HIV and malaria combined. Patients dying of curable neurosurgical conditions solely because of inadequacy or absence of neurosurgical infrastructure is an issue deserving immediate attention and action. Global neurosurgery is an important step forward in this regard, under which different models of collaboration between HICs and LMICs aim to increase both the number of neurosurgeons as well the quality of neurosurgical care available in these countries through arranging surgical camps, providing neurosurgical training and education, and restructuring the health system in these countries in order to create an environment conducive to the provision of the highest form of neurosurgical care. Despite the many challenges faced by LMICs in furthering neurosurgery programs such as poor resource allocation, brain drain, turbulent socioeconomic conditions, limited training facilities, and population explosion, data now being reported from LMICs the world over, exemplifies the immense positive impact that collaborations have had over the last few decades in improving neurosurgical capacity and infrastructure. So far, conventional methods of collaboration (i.e. neurosurgical missions to LMICs and training of neurosurgeons in HICs) have been effective in progressively bringing about the desired change in LMICs. However, these methods have been limited by a finite funding, pushing the global neurosurgical community to look for alternatives such as online curricula, task shifting and sharing, and long distance mentor-mentee relationships. In this review, we aim to provide an update on the current state of neurosurgical collaborations and identify the barriers in the way of collaborations and what alternative models of collaboration might be used to overcome them..
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Affiliation(s)
- Aqeeb Ur Rehman
- Department of Neurosurgery, King Edward Medical University, Lahore
| | - Aleena Ahmed
- Department of Neurology, King Edward Medical University, Lahore
| | - Zaofsha Zaheer
- Department of Neurology, King Edward Medical University, Lahore
| | - Bakhtawar Ahmed
- Department of Neurology, University of Florida, Gainesville, Florida
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Lassarén P, Tewarie IA, Gerstl JVE, Florman JE, Smith TR, Broekman MLD. Telemedicine and the right to health: A neurosurgical perspective. J Clin Neurosci 2022; 102:71-74. [PMID: 35738183 DOI: 10.1016/j.jocn.2022.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/24/2022]
Abstract
Neurosurgical task force is limited and unevenly distributed. Telemedicine has become increasingly popular, and could help neurosurgical centers meet patient right to care. This scoping review aims to evaluate the impact and feasibility of telemedicine on the right to neurosurgical care, using the AAAQ toolbox. The AAAQ toolbox consists of Availability, Accessibility, Acceptability and Quality. Neurosurgical availability is limited by the number of neurosurgeons, but by using task shifting and -sharing via telemedicine, the number of patients receiving neurosurgical care could increase without increasing the number of neurosurgeons. Telemedicine can improve geographic accessibility to neurosurgical care, but may also introduce technological literacy barriers. Acceptability of telemedicine is a double-edged sword; while a useful service, telemedicine also creates ethical concerns regarding privacy and confidentiality. Regulations and adaptations for vulnerable patient groups are key considerations for deploying telemedicine. Finally, there is emerging evidence that the quality of remote neurosurgical diagnostics and care can keep high standards. Overall, telemedicine has the potential of taking neurosurgery one step closer to meeting patient right to health, globally.
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Affiliation(s)
- Philipp Lassarén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Computational Neurosciences Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.
| | - Ishaan A Tewarie
- Computational Neurosciences Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands; Faculty of Medicine, Erasmus University Rotterdam/Erasmus Medical Center Rotterdam, The Netherlands
| | - Jakob V E Gerstl
- Computational Neurosciences Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Neurosurgery, Maine Medical Center, Portland, ME, United States
| | - Jeffrey E Florman
- Department of Neurosurgery, Maine Medical Center, Portland, ME, United States
| | - Timothy R Smith
- Computational Neurosciences Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Neurosurgery, Brigham and Women's Hospital, Harvard University, Boston, MA, United States
| | - Marike L D Broekman
- Computational Neurosciences Outcomes Center (CNOC), Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Neurosurgery, Haaglanden Medical Center, The Hague, The Netherlands; Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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5
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Hewitt JN, Ovenden CD, Glynatsis JM, Sabab A, Gupta AK, Kovoor JG, Wells AJ, Maddern GJ. Emergency Neurosurgery Performed by General Surgeons: A Systematic Review. World J Surg 2021. [PMID: 34766194 DOI: 10.1007/s00268-021-06363-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND In under-resourced settings, general surgeons may be called upon to perform emergency operations within other specialties. Accordingly, we aimed to characterise patient outcomes after emergency neurosurgery performed by a general surgeon or general surgery trainee. METHODS PubMed, Embase and the Cochrane Library were searched to 30 May 2021 for observational studies reporting outcomes after emergency neurosurgery performed by a general surgeon. Study screening, data extraction, and risk of bias using the Downs and Black checklist were performed in duplicate. Data on setting, operation undertaken, mortality rates and complications were extracted. Meta-analysis was planned but not possible due to heterogeneity. This study is registered with PROSPERO, CRD42021258097. RESULTS From 632 records, 14 retrospective observational studies were included, covering a total sample of 1,988 operations. Four studies were from Australia, and the remaining 10 were, respectively, from 10 other countries. Most common operations performed were decompressive surgery with burr holes or craniectomy for head trauma and insertion of intracranial pressure monitors. Rural hospitals were the most common settings. Mortality rates for procedures performed by general surgeons at latest follow-up were heterogenous, ranging from 5% for evacuation of chronic subdural haematoma in Kenya to 81% in head injured patients in a Hong Kong study. CONCLUSIONS This is the first systematic review that synthesises the literature to characterise patient outcomes after neurosurgical operations performed by a general surgeon. Findings from this study may benefit global surgery performed in rural, remote, military or humanitarian settings.
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Umana GE, Scalia G, Yagmurlu K, Mineo R, Di Bella S, Giunta M, Spitaleri A, Maugeri R, Graziano F, Fricia M, Nicoletti GF, Tomasi SO, Raudino G, Chaurasia B, Bellocchi G, Salvati M, Iacopino DG, Cicero S, Visocchi M, Strigari L. Multimodal Simulation of a Novel Device for a Safe and Effective External Ventricular Drain Placement. Front Neurosci 2021; 15:690705. [PMID: 34194297 PMCID: PMC8236630 DOI: 10.3389/fnins.2021.690705] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background External ventricular drain (EVD) placement is mandatory for several pathologies. The misplacement rate of the EVD varies widely in literature, ranging from 12.3 to 60%. The purpose of this simulation study is to provide preliminary data about the possibility of increasing the safety of one of the most common life-saving procedures in neurosurgery by testing a new device for EVD placement. Methods We used a novel guide for positioning the ventricular catheter (patent RM2014A000376). The trajectory was assessed using 25 anonymized head CT scans. The data sets were used to conduct three-dimensional computer-based and combined navigation and augmented reality-based simulations using plaster models. The data set inclusion criteria were volumetric head CT scan, without midline shift, of patients older than 18. Evans' index was used to quantify the ventricle's size. We excluded patients with slit ventricles, midline shift, skull fractures, or complex skull malformations. The proximal end of the device was tested on the cadaver. Results The cadaveric tests proved that a surgeon could use the device without any external help. The multimodal simulation showed Kakarla grade 1 in all cases but one (grade 2) on both sides, after right and left EVD placement. The mean Evans' index was 0.28. The geometric principles that explain the device's efficacy can be summarized by studying the properties of circumference and chord. The contact occurs, for each section considered, at the extreme points of the chord. Its axis, perpendicular to the plane tangent to the spherical surface at the entry point, corresponds to the direction of entry of the catheter guided by the instrument. Conclusion According to our multimodal simulation on cadavers, 3D computer-based simulation, 3D plaster modeling, 3D neuronavigation, and augmented reality, the device promises to offer safer and effective EVD placement. Further validation in future clinical studies is recommended.
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Affiliation(s)
- Giuseppe Emmanuele Umana
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Gianluca Scalia
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance "Garibaldi," Catania, Italy
| | - Kaan Yagmurlu
- Department of Neurological Surgery, University of Virginia, Charlottesville, VA, United States
| | - Rosalia Mineo
- MT Ortho Srl, Aci Sant'Antonio, Catania, Italy.,DICAR, University of Catania, Catania, Italy
| | - Simone Di Bella
- MT Ortho Srl, Aci Sant'Antonio, Catania, Italy.,DICAR, University of Catania, Catania, Italy
| | | | - Angelo Spitaleri
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Rosario Maugeri
- Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone," Palermo, Italy
| | - Francesca Graziano
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance "Garibaldi," Catania, Italy.,Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone," Palermo, Italy
| | - Marco Fricia
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Giovanni Federico Nicoletti
- Department of Neurosurgery, Highly Specialized Hospital and of National Importance "Garibaldi," Catania, Italy
| | - Santino Ottavio Tomasi
- Department of Neurosurgery, Christian-Doppler-Klinik, Paracelsus Private Medical University, Salzburg, Austria
| | - Giuseppe Raudino
- Department of Neurosurgery, Humanitas University, Catania, Italy
| | - Bipin Chaurasia
- Department of Neurosurgery, Neurosurgery Clinic, Birgunj, Nepal
| | - Gianluca Bellocchi
- Department of Otorhinolaryngology, San Camillo Forlanini Hospital, Rome, Italy
| | - Maurizio Salvati
- Department of Neurosurgery, Policlinico Tor Vergata, Rome, Italy
| | - Domenico Gerardo Iacopino
- Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, AOUP "Paolo Giaccone," Palermo, Italy
| | - Salvatore Cicero
- Department of Neurosurgery, Trauma Center, Gamma Knife Center, Cannizzaro Hospital, Catania, Italy
| | - Massimiliano Visocchi
- Craniovertebral Junction Operative Unit, Master CVJ Surgical Approach Research Center, Institute of Neurosurgery, Policlinic "A. Gemelli", Catholic University, Rome, Italy
| | - Lidia Strigari
- Department of Medical Physics, IRCCS University Hospital of Bologna, Bologna, Italy
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7
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Grabski DF, Ajiko M, Kayima P, Ruzgar N, Nyeko D, Fitzgerald TN, Langer M, Cheung M, Cigliano B, D'Agostino S, Baird R, Duffy D, Tumukunde J, Nabukenya M, Ogwang M, Kisa P, Sekabira J, Kakembo N, Ozgediz D. Access to pediatric surgery delivered by general surgeons and anesthesia providers in Uganda: Results from 2 rural regional hospitals. Surgery 2021:S0039-6060(21)00426-8. [PMID: 34130809 DOI: 10.1016/j.surg.2021.05.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 04/27/2021] [Accepted: 05/04/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Significant limitations in pediatric surgical capacity exist in low- and middle-income countries, especially in rural regions. Recent global children's surgical guidelines suggest training and support of general surgeons in rural regional hospitals as an effective approach to increasing pediatric surgical capacity. METHODS Two years of a prospective clinical database of children's surgery admissions at 2 regional referral hospitals in Uganda were reviewed. Primary outcomes included case volume and clinical outcomes of children at each hospital. Additionally, the disability-adjusted life-years averted by delivery of pediatric surgical services at these hospitals were calculated. Using a value of statistical life calculation, we also estimated the economic benefit of the pediatric surgical care currently being delivered. RESULTS From 2016 to 2019, more than 300 surgical procedures were performed at each hospital per year. The majority of cases were standard general surgery cases including hernia repairs and intussusception as well as procedures for surgical infections and trauma. In-hospital mortality was 2.4% in Soroti and 1% in Lacor. Pediatric surgical capacity at these hospitals resulted in over 12,400 disability-adjusted life-years averted/year. This represents an estimated economic benefit of 10.2 million US dollars/year to the Ugandan society. CONCLUSION This investigation demonstrates that lifesaving pediatric procedures are safely performed by general surgeons in Uganda. General surgeons who perform pediatric surgery significantly increase surgical access to rural regions of the country and add a large economic benefit to Ugandan society. Overall, the results of the study support increasing pediatric surgical capacity in rural areas of low- and middle-income countries through support and training of general surgeons and anesthesia providers.
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Bartlett HH, Huie K, Ginalis E, Jumah F, Raju B, Nanda A. Legacies of Neurosurgery and its Implications on Global Neurosurgery Today. World Neurosurg 2021:S1878-8750(21)00822-6. [PMID: 34098138 DOI: 10.1016/j.wneu.2021.05.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 11/20/2022]
Abstract
Trephination, the practice of boring a hole in ones skull, is one of the oldest surgical procedures performed by and on man. Fossil records show evidence of trephined skulls on separate continents throughout ancient history. Even more remarkably, fossils show that ancient humans actually survived the procedure, some more than once. Ancient mythologies and texts provide context to the fossil record, indicating that trephination was performed some of the time for medical indications, including traumatic head injury and intractable neurological conditions. In modern day, traumatic brain injury accounts for a significant percentage of the overall global burden of disease and its incidence is disproportionately increasing in low-and-middle-income countries. In critical situations neurosurgical intervention may be indicated. The burr hole procedure, or trephination, was identified as an essential surgical procedures that all first-level hospitals should be able to perform; however, there exists a dramatic lack of access to neurosurgical specialists and care globally, especially among low-and-middle-income countries. Task-shifting/sharing is one paradigm that may be used effectively to broaden access to this life-saving procedure but it is at the moment a contested practice.
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Hamamoto Filho PT, Módolo GP, Macedo de Freitas CC, Zanini MA, Bazan R. Thrombectomy for Stroke in Brazil-Late Evidence or Promising Future? Front Surg 2021; 8:651183. [PMID: 33996885 PMCID: PMC8113624 DOI: 10.3389/fsurg.2021.651183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/15/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Pedro Tadao Hamamoto Filho
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, Brazil
| | - Gabriel Pinheiro Módolo
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, Brazil
| | | | - Marco Antônio Zanini
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, Brazil
| | - Rodrigo Bazan
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, Brazil
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Abstract
The field of neurosurgery has always been propelled by the adoption of novel technologies to improve practice. Although advancements have occurred in the diagnosis, treatment, and long-term outcomes of patients, these have not translated to global patient benefit. Up to five million people each year do not have access to safe and affordable neurosurgical interventions, and those in low- and middle-income countries (LMICs) are disproportionately affected. Current approaches to increase neurosurgical capacity are unlikely to meet the UN Sustainable Development Goals target by 2030, and many of the most successful programs have been disrupted by the travel restrictions of the COVID-19 pandemic. There is therefore a pressing need for creative virtual solutions. An area of growing relevance is the use of immersive technologies: virtual reality (VR) and augmented reality (AR). AR allows additional information to be superimposed onto the surgeon's visual field, thus enhancing intra-operative visualization. This can be used for remote tele-proctoring, whereby an experienced surgeon can virtually assist with a procedure regardless of geographical location. Expert guidance can therefore be given to both neurosurgical trainees and non-neurosurgical practitioners, further facilitating the growing practice of neurosurgical task-shifting in LMICs. VR simulation is another useful tool in remote neurosurgical training, with the potential to reduce the learning curve of complex procedures whilst conserving supplies in low-resource settings. The adoption of immersive technologies into practice is therefore a promising approach for achieving global neurosurgical equity, whilst adapting to the long-term disruptions of the pandemic.
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Satarasinghe P, Shah D, Koltz MT. The Perception and Impact of Relative Value Units (RVUs) and Quality-of-Care Compensation in Neurosurgery: A Literature Review. Healthcare (Basel) 2020; 8:healthcare8040526. [PMID: 33271871 PMCID: PMC7711854 DOI: 10.3390/healthcare8040526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/14/2020] [Accepted: 11/27/2020] [Indexed: 11/16/2022] Open
Abstract
The debate surrounding the integration of value in healthcare delivery and reimbursement reform has centered around integrating quality metrics into the current fee-for-service relative value units (RVU) payment model. Although a great amount of literature has been published on the creation and utilization of the RVU, there remains a dearth of information on how clinicians from various specialties view RVU and the quality-of-care metric in the compensation formula. The aim of this review is to analyze and consolidate existing theories on the RVU payment model in neurosurgery. Google and PubMed were searched for English-language literature describing opinions on the RVU in neurosurgery. Commentary was noted to be primary opinions if it was mentioned at least twice in the eight articles included in this review. Overall, seven primary opinions on the RVU were identified across the analyzed articles. Integration of quality into the RVU is viewed favorably by neurosurgeons with a few caveats and opportunities for further improvement.
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Affiliation(s)
- Praveen Satarasinghe
- Department of Neurosurgery, Dell Medical School, 1501 Red River Street, Austin, TX 78723, USA; (P.S.); (D.S.)
| | - Darsh Shah
- Department of Neurosurgery, Dell Medical School, 1501 Red River Street, Austin, TX 78723, USA; (P.S.); (D.S.)
| | - Michael T. Koltz
- Department of Neurosurgery, Dell Medical School, 1501 Red River Street, Austin, TX 78723, USA; (P.S.); (D.S.)
- Department of Neurosurgery, Seton Brain and Spine Institute, 301 Seton Parkway, Round Rock, TX 78665, USA
- Correspondence:
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12
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Legaspi GD, Omar AT, Baticulon RE, Salonga AEM, Gaddi MJS, Hong MAC, Seng KS, Khu KJO. Letter to the Editor "Service and Training During the COVID-19 Pandemic: Perspectives from a Neurosurgical Center in the Philippines". World Neurosurg 2020; 139:741-743. [PMID: 32450311 PMCID: PMC7255173 DOI: 10.1016/j.wneu.2020.05.138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/03/2022]
Affiliation(s)
- Gerardo D Legaspi
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Abdelsimar T Omar
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines.
| | - Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Alaric Emmanuel M Salonga
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Mairre James S Gaddi
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Manilyn Ann C Hong
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Kenny S Seng
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
| | - Kathleen Joy O Khu
- Division of Neurosurgery, Department of Neurosciences, University of the Philippines - Philippine General Hospital, Manila, Philippines
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