Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

National study on access to surgical services shows substantial regional variations

08 February 2019

County of residence appears to have an influence on a patients’ accessibility to certain surgical procedures, according to research led by RCSI. The national study on geographical variation in access to general surgery in Ireland analysed over 900,000 episodes of public hospital care around the country.

The study found large variations in utilisation between the studied counties, suggesting that a person’s likelihood of undergoing a specific procedure may be related to their county of residence. This variation in the utilisation rate of general surgical procedures may suggest excessive overuse in some regions or inappropriate underutilisation in other areas.

Most procedures were carried out at substantially higher rates outside the larger cities (Dublin, Galway and Waterford). Geographically, surgical access was the lowest in Co Galway with four out of six procedures indicating substantially lower rates than the rest of the national population.

Despite an approximate quarter of the population residing in Dublin, operation rates were considerably lower than the rates of residents outside of the capital. This may reflect the prioritisation given to cancer cases and a resulting lack of bed availability for elective, non-cancer operations in some centres.

Lead author Ms Ola Ahmed said, “Geographic patterns reflect not only the localisation of disorders, but also the social and economic environment in which healthcare is being provided. Studies of this nature are important for health policy and planning."

“These findings imply a need for improved surgical access at a regional level by facilitating the integration of public policies and promoting services at the appropriate settings”, concluded Ms Ahmed.

The research is published in The Surgeon. It was carried out by Ola Ahmed, Department of General Surgery, Wexford General Hospital, Professor Kenneth Mealy, RCSI President and National Clinical Programme for Surgery, Gerry Kelliher, National Clinical Programme for Surgery, Professor Frank Keane, National Clinical Programme for Surgery and Prof Jan Sorensen, Healthcare Outcomes Research Centre, RCSI.