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Bakhshi SK, Shah Z, Khalil M, Khan Mughal MA, Kazi AM, Virani QUA, Jooma R, Dewan MC, Shamim MS. Geographical Distribution of Neurosurgeons and Emergency Neurosurgical Services in Pakistan. World Neurosurg 2023; 179:e515-e522. [PMID: 37683928 DOI: 10.1016/j.wneu.2023.08.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND AND OBJECTIVE According to the World Federation of Neurosurgical Societies (WFNS), a minimum neurosurgery workforce density should be 1 per 200,000 population for optimum access to neurosurgical care. Pakistan lags behind in the number of neurosurgeons, and disproportionate geographical distribution further increases disparity. Our objective was to geographically map the density of neurosurgeons and emergency neurosurgical services (ENS) in Pakistan. METHODS This survey was circulated among 307 neurosurgeons. Data were analyzed using SPSS v21. The number of neurosurgeons and ENS were plotted on the population density map using ArcGIS Pro 3.0.0 software. RESULTS Three hundred and seven neurosurgeons working at 74 centers responded to our survey (93.3% coverage). The current density of neurosurgeons in Pakistan is 0.14/100,000. The 2 more populous provinces, Punjab and Sindh, have 42.3% (130) and 35.8% (110) neurosurgeons, respectively. They also housed nearly 3 quarters of all the neurosurgery centers in urban districts. Karachi and Lahore accommodate 135 (44%) of all the country's neurosurgeons, having 0.29 and 0.51 neurosurgeons/100,000 respectively. Management of traumatic brain injury is offered at 65 centers (87.8%). Nearly all centers are equipped with computed tomography (CT) scan machine (74; 97%), but magnetic resonance imaging (MRI) facility is available at 55 (72%) centers and 37 (49%) centers have angiography suites. Sixty nine centers (93.2%) have C-arm fluoroscopes available. CONCLUSIONS The geographical mapping of neurosurgeons and neurosurgical facilities is highly skewed towards urban centers, increasing disparity in access to timely neurosurgical emergency services. Four times more neurosurgeons are required in Pakistan to bridge the gap in neurosurgical workforce.
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Affiliation(s)
- Saqib Kamran Bakhshi
- Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Zara Shah
- Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Mujtaba Khalil
- Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - M Ayub Khan Mughal
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Abdul Momin Kazi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Qurat-Ul-Ain Virani
- Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Rashid Jooma
- Section of Neurosurgery, Department of Surgery, Aga Khan University, Karachi, Pakistan
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Jung M, Lee BJ, Lee S, Shin J. Clinical outcomes and predictors of a gap in direct-acting oral anticoagulant therapy in the elderly: A time-varying analysis of a nationwide cohort study. Thromb Res 2023; 226:61-68. [PMID: 37121013 DOI: 10.1016/j.thromres.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 04/03/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
INTRODUCTION As direct-acting oral anticoagulants (DOACs) have short half-lives of around 12 h, even a short gap in DOAC therapy may diminish anticoagulation effects, increasing risks of adverse clinical outcomes. We aimed to evaluate clinical consequences of a gap in DOAC therapy with atrial fibrillation (AF) and to identify its potential predictors. MATERIALS AND METHODS In this retrospective cohort study, we included DOAC users aged over 65 years with AF from the 2018 Korean nationwide claims database. We defined a gap in DOAC therapy as no claim for a DOAC one or more days after the due date of a refill prescription. We used a time-varying-analysis method. The primary outcome was a composite of death and thrombotic events including ischemic stroke/transient ischemic attack or systemic embolism. Potential predictors of a gap included sociodemographic and clinical factors. RESULTS AND CONCLUSIONS Among 11,042 DOAC users, 4857 (44.0 %) patients had at least one gap. Standard national health insurance, non-metropolitan locations of medical institutions, history of liver disease, chronic obstructive pulmonary disease, cancer, or dementia, and use of diuretics or non-oral agents were associated with increased risks of a gap. In contrast, history of hypertension, ischemic heart disease, or dyslipidemia were associated with a decreased risk of a gap. A short gap in DOAC therapy was significantly associated with a higher risk of the primary outcome compared to no gap (hazard ratio 4.04, 95 % confidence interval 2.95-5.52). The predictors could be utilized to identify at-risk patients to provide additional support to prevent a gap.
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Affiliation(s)
- Minji Jung
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA, United States
| | - Beom-Jin Lee
- Research Institute of Pharmaceutical Sciences and Technology, Ajou University, Suwon, Republic of Korea
| | - Sukhyang Lee
- Division of Clinical Pharmacy, College of Pharmacy, Ajou University, Suwon, Republic of Korea.
| | - Jaekyu Shin
- Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA, United States.
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Ukachukwu AEK, Still MEH, Seas A, von Isenburg M, Fieggen G, Malomo AO, Shokunbi MT, Egger JR, Haglund MM, Fuller AT. Fulfilling the specialist neurosurgical workforce needs in Africa: a systematic review and projection toward 2030. J Neurosurg 2022; 138:1102-1113. [PMID: 35962968 DOI: 10.3171/2022.2.jns211984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 02/14/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Africa contributes significantly to the global neurosurgical disease burden but has only 1% of the neurosurgery workforce. This study appraises the neurosurgical workforce and training capacity in Africa and projects the workforce capacity by 2030. METHODS The authors conducted a systematic review of the online literature on neurosurgical workforce and training in Africa obtained from three journal databases (PubMed, Embase, and African Index Medicus), as well as from a gray literature search, between September and December 2020. Included literature passed a two-level screening conducted using a systematic review software by a team of two independent reviewers. Data were extracted from selected articles and documented and analyzed on spreadsheets. RESULTS One hundred and fifty-nine eligible articles were analyzed: 1974 neurosurgeons serve 1.3 billion people in Africa (density 0.15 per 100,000 persons, ratio 1:678,740), with uneven distribution between the regions. North Africa has 64.39% of the neurosurgical workforce (n = 1271), followed by Southern Africa (12.66%, n = 250), West Africa (11.60%, n = 229), East Africa (8.26%, n = 163), and Central Africa (3.09%, n = 61). At an exponential growth rate of 7.03% (95% CI 5.83%-8.23%) per annum, Africa will have 3418 (95% CI 1811-6080) neurosurgeons by 2030, with a deficit of 5191 neurosurgeons, based on population workforce targets. In terms of training, there are 106 neurosurgery training institutions in 26 African countries. North Africa has 52 training centers (49.05%), West Africa 23 (21.70%), East Africa 15 (14.15%), Southern Africa 14 (13.21%), and Central Africa 2 (1.89%). The major regional training programs are those of the West African College of Surgeons (24 sites in 7 countries) and the College of Surgeons of East, Central, and Southern Africa (17 sites in 8 countries). CONCLUSIONS The study is limited as it is based on the online literature, some of which includes modeled estimates with questionable reliability. However, the results indicate that while countries in North Africa are expected to surpass their population workforce requirements, sub-Saharan African countries are likely to have significant workforce deficits accentuated by the paucity of neurosurgery training programs. To meet the 2030 population workforce requirements, the continent's exponential growth rate should be scaled up to 15.87% per annum. Scaling up neurosurgical training would help to meet this target and requires collaborative efforts from continental, regional, and national agencies and international organizations.
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Affiliation(s)
- Alvan-Emeka K Ukachukwu
- 1Duke Global Neurosurgery and Neurology, Duke University, Durham.,2Department of Neurosurgery, Duke University Health System, Durham, North Carolina.,3Neurosurgery Unit, Asokoro District Hospital, Abuja FCT, Nigeria
| | - Megan E H Still
- 4Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Andreas Seas
- 1Duke Global Neurosurgery and Neurology, Duke University, Durham
| | - Megan von Isenburg
- 5Duke University Medical Center Library and Archives, Durham, North Carolina
| | - Graham Fieggen
- 6Division of Neurosurgery and Neuroscience Institute, University of Cape Town, South Africa
| | - Adefolarin O Malomo
- 7Department of Neurological Surgery, College of Medicine, University of Ibadan, Nigeria; and
| | - Matthew T Shokunbi
- 7Department of Neurological Surgery, College of Medicine, University of Ibadan, Nigeria; and
| | - Joseph R Egger
- 8Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Michael M Haglund
- 1Duke Global Neurosurgery and Neurology, Duke University, Durham.,2Department of Neurosurgery, Duke University Health System, Durham, North Carolina.,8Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Anthony T Fuller
- 1Duke Global Neurosurgery and Neurology, Duke University, Durham.,2Department of Neurosurgery, Duke University Health System, Durham, North Carolina.,8Duke Global Health Institute, Duke University, Durham, North Carolina
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Rolle ML, Garba DL, Buda A, Vital A, Ekedede M. Timely Access to Neurosurgical Care in the Caribbean Using Geospatial Analysis. World Neurosurg 2021; 151:e545-e551. [PMID: 33905905 DOI: 10.1016/j.wneu.2021.04.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/16/2021] [Accepted: 04/17/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Access to timely neurosurgical care in particular remains limited worldwide, and is associated with increased morbidity and mortality, a decrease in overall life expectancy, and catastrophic economic costs. To date, access to neurosurgical care has not been completely studied and reported in the Caribbean neurosurgical literature. In this study, we aim to understand the geographic distribution of hospital facilities with neurosurgical capacity among the CARICOM member states to determine timely access to neurosurgical care. METHODS We assessed geographical access to facilities capable of providing neurosurgical care in the Caribbean. The GPS coordinates of the hospitals that provide neurosurgical care were identified using street addresses and satellite imaging from Google Maps. Facilities with neurosurgical care were mapped in ArcGIS Pro (Version 2.6.0). using Manhattan distance. We identified the area around each facility and stratified by 30- minute, 1-hour, 2-hour, and 4-hour geographic driving intervals. RESULTS A total of 16 hospitals were identified as providing neurosurgical care in the Caribbean. Our results suggest that 14 million people (76% of the population) had 4-hour geographic access to a facility capable of providing neurosurgical care. In addition, 7 million people (40% of the population) had 2-hour geographical access to neurosurgical care. CONCLUSIONS Timely access to care is an important tenet of global neurosurgery. We found that 3.5 million Caribbean residents are outside of the access zone to neurosurgical capacity. Public health advocates, governments, providers, and patients should be aware of the inequity in access to neurosurgical care and should collectively work to close the gap.
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Affiliation(s)
- Myron L Rolle
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Deen L Garba
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA; University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA.
| | - Alexandra Buda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA; University of Rochester School of Medicine, Rochester, New York, USA
| | - Anchelo Vital
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts, USA; State University of Haiti Faculty of Medicine and Pharmacy, Port-au-Prince, Ouest, Haiti
| | - Magnus Ekedede
- Department of Neurosurgery, Princess Margaret Hospital, Nassau, Bahamas
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Jang Y, Park SY, Kim B, Lee E, Lee S, Son HJ, Park JW, Yu SN, Kim T, Jeon MH, Choo EJ, Kim TH. Infectious Diseases Physician Workforce in Korea. J Korean Med Sci 2020; 35:e428. [PMID: 33350186 PMCID: PMC7752260 DOI: 10.3346/jkms.2020.35.e428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 11/30/2020] [Indexed: 12/25/2022] Open
Abstract
This study aimed to evaluate the infectious disease (ID) physician workforce in Korea. We investigated the acquisition of ID physicians from 1992 to 2019 with their current working place in the Health Care System. We defined ID physicians working at general or tertiary-care hospitals as active ID physicians. A total 275 physicians acquired ID as a sub-specialty. Among the 275, 242 were active ID physicians. The density of active ID physicians was 0.47 per 100,000 population. Of all the 17 administrative districts, 11 (64.7%) fell short of 0.47, and 131 medical institutions employed the service of ID physicians. The median number of beds per adult ID physician was 372 (interquartile range, 280-507). It is essential to secure human resources to respond to emerging infectious diseases and perform the inherent work of ID physicians.
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Affiliation(s)
- Youngeun Jang
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Se Yoon Park
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
| | - Bongyoung Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Eunjung Lee
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Seungjae Lee
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hyo Ju Son
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jung Wan Park
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Shi Nae Yu
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Tark Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Min Hyok Jeon
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Eun Ju Choo
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Tae Hyong Kim
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
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Saito H, Tanimoto T, Kami M, Suzuki Y, Morita T, Morita M, Yamamoto K, Shimada Y, Tsubokura M, Endo M. New physician specialty training system impact on distribution of trainees in Japan. Public Health 2020; 182:143-150. [PMID: 32305513 DOI: 10.1016/j.puhe.2020.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/13/2020] [Accepted: 02/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The problem of uneven distribution of medical services and inequitable distribution of physicians is drawing much attention worldwide. Revealing how changes in the specialty training system in Japan have affected the distribution of doctors could help us understand this problem. In 2018, a new and standardized specialty training system was implemented by the Japanese Medical Specialty Board, which is recognized by the Ministry of Health, Labor and Welfare. The purpose of this study was to investigate how this new system has affected the geographical distribution of doctors commencing specialty training (trainees) and choice of specialty in Japan. STUDY DESIGN Retrospective observational study. METHODS The change in the number of trainees between the control period (2012-2014) and 2018 was investigated, taking into account the prefecture and specialty selected. Population, the proportion of residents aged 65 years or older (aging rate), and the total number of overall doctors in each prefecture were considered as the background characteristics of each prefecture. We created a Lorenz curve and calculated the Gini coefficient for the distribution of trainees. RESULTS In 2018, the number of trainees per 100,000 population increased to 6.6 nationwide compared with 5.5 during the control period. The number of trainees per 100,000 population in 2018 increased in prefectures with a large population of ≧ 2,000,000, a low aging rate (<27%), and a high doctor density (≧ 250 doctors per 100,000 population). The Gini coefficient showed an increase to 0.226 in 2018 compared with only 0.160 during the control period. CONCLUSIONS After the implementation of the new training system, there was an increase in the number of doctors enrolling in specialty programs, and the specialties other than internal medicine and surgery have attracted more trainees. Inequality in the distribution of doctors between urban and rural prefectures worsened. This indicates the need to explore new ways of balancing distribution while maintaining optimal opportunities for specialist training.
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Affiliation(s)
- H Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
| | - T Tanimoto
- Department of Internal Medicine, Navitas Clinic, Tachikawa, Tokyo, Japan
| | - M Kami
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Y Suzuki
- Department of Obstetrics and Gynecology, Tone Central Hospital, Numata, Gunma, Japan
| | - T Morita
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - M Morita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - K Yamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Y Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - M Tsubokura
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - M Endo
- Support Office for Medical Education and Trainings, Sendai Kousei Hospital, Sendai, Miyagi, Japan
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Park HR, Park SQ, Park HK, Im SB, Yoon SM, Kim BT. Current Training Status of Neurosurgical Residents in South Korea: A Nationwide Multicenter Survey. World Neurosurg 2019; 131:e329-e338. [PMID: 31356983 DOI: 10.1016/j.wneu.2019.07.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND In South Korea, special legislation was introduced in December 2016 to limit residents' training time to a maximum of 80 hours per week. The aim of this study was to survey the current training system and environment of neurosurgical residents and to find ways to improve the quality of neurosurgical training. METHODS The questionnaire survey included 373 neurosurgical residents at 66 training hospitals nationwide, who were members of the Korean Neurosurgical Society. The survey method included a questionnaire link through a text message and was carried out anonymously. The survey was conducted for 7 days and targeted a total of 106 residents (28.4%). RESULTS Most respondents selected "excessive training time" as a reason for dissatisfaction with the training environment (n = 61, 57.5%), followed by "limited number of opportunities for surgery" (n = 50, 47.2%), and "little experience for research" (n = 42, 39.6%). Respondents still believe that they have to work excessively longer, even after 80 hours of training per week. CONCLUSIONS The major reason that neurosurgical residents are dissatisfied with the current training system and environment is the excessive time spent on it. These survey results are expected to be used as the basis for improvement of the residents' training system and work environment in South Korea.
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Affiliation(s)
- Hye Ran Park
- Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Sukh Que Park
- Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Hyung Ki Park
- Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, South Korea
| | - Soo-Bin Im
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Buecheon, South Korea
| | - Seok Mann Yoon
- Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea
| | - Bum-Tae Kim
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Buecheon, South Korea.
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Kim TG, Kwon O, Shin YS, Sung JH, Koh JS, Kim BT. Endovascular Treatments Performed Collaboratively by the Society of Korean Endovascular Neurosurgeons Members : A Nationwide Multicenter Survey. J Korean Neurosurg Soc 2019; 62:502-518. [PMID: 31288507 PMCID: PMC6732345 DOI: 10.3340/jkns.2018.0216] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 12/24/2018] [Indexed: 11/27/2022] Open
Abstract
Objective Since less invasive endovascular treatment was introduced to South Korea in 1994, a considerable proportion of endovascular treatments have been performed by neuroradiology doctors, and endovascular treatments by vascular neurosurgeons have recently increased. However, few specific statistics are known regarding how many endovascular treatments are performed by neurosurgeons. Thus, authors compared endovascular treatments collaboratively performed by vascular neurosurgeons with all cases throughout South Korea from 2013 to 2017 to elucidate the role of neurosurgeons in the field of endovascular treatment in South Korea.
Methods The Society of Korean Endovascular Neurosurgeons (SKEN) has issued annual reports every year since 2014. These reports cover statistics on endovascular treatments collaboratively or individually performed by SKEN members from 2013 to 2017. The data was requested and collected from vascular neurosurgeons in various hospitals. The study involved 77 hospitals in its first year, and 100 in its last. National statistics on endovascular treatment from all over South Korea were obtained from the Healthcare Bigdata Hub website of the Health Insurance Review & Assessment Service based on the Electronic Data Interchange (EDI) codes (in the case of intra-arterial (IA) thrombolysis, however, statistics were based on a combination of the EDI and I63 codes, a cerebral infarction disease code) from 2013 to 2017. These two data sets were directly compared and the ratios were obtained.
Results Regionally, during the entire study period, endovascular treatments by SKEN members were most common in Gyeonggi-do, followed by Seoul and Busan. Among the endovascular treatments, conventional cerebral angiography was the most common, followed by cerebral aneurysmal coiling, endovascular treatments for ischemic stroke, and finally endovascular treatments for vascular malformation and tumor embolization. The number of endovascular treatments performed by SKEN members increased every year.
Conclusion The SKEN members have been responsible for the major role of endovascular treatments in South Korea for the recent 5 years. This was achieved through the perseverance of senior members who started out in the midst of hardship, the establishment of standards for the training/certification of endovascular neurosurgery, and the enthusiasm of current SKEN members who followed. To provide better treatment to patients, we will have to make further progress in SKEN.
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Affiliation(s)
- Tae Gon Kim
- Department of Neurosurgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Oki Kwon
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yong Sam Shin
- Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Hoon Sung
- Department of Neurosurgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jun Seok Koh
- Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Bum-Tae Kim
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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