International comparisons of surgical procedures
There are large cross-country variations in the population level rates of some common operations - in particular, coronary bypass and angioplasty surgeries, hip and knee replacements and caesarean sections. For all these procedures it is difficult to determine what the right absolute level should be. However, trends and variations can inform us about potential problems in the quality of care provided.
These indicators are prepared by the Organisation for Economic Co-operation and Development (OECD) as part of their Health at a Glance edition. Definition and comparability notes from OECD Health at a Glance 2013:
Cardiac procedures: data for most countries covers both inpatient and outpatient day cases, with the exception of the United States, where only inpatient cases are included. This results in under-estimation of coronary angioplasties but does not affect the number of coronary artery bypasses as most patients stay at least one night in the hospital. In the UK and New Zealand the data only includes activities in publicly funded hospitals, resulting in an under-estimation. Data for Spain only partially include activities in private hospitals.
Knee and hip replacement: classification systems and registration practices vary across countries and may affect the comparability of the data. Most countries also include practical hip replacement in the figures. In New Zealand and the UK, the data only include activities in publicly-funded hospitals, which may result in underestimation (an estimated 15% of all hospital activity is undertaken in private hospitals). Data for Spain only partially include activities in private hospitals.
The caesarean section rate is the number of caesarean deliveries per 1000 live births.