Outcome analysis of the impact of a pediatric surgeon in a regional hospital as an indicator of the importance of subspecialty trained surgeons

SummaryObjectivePediatric surgeons (PS) are specialists in surgical fields, however, not all regional hospitals have the service of a PS. The aim of this study was to analyze the outcome of pediatric surgeries in a regional hospital with and without a PS and to evaluate the need for PS in regional hospitals.MethodsStatistics from all pediatric surgeries between December 2002 and November 2004 were collected at Cheng Ching Hospital and divided into group I (without a PS) and group II (with a PS).ResultsThere were 365 pediatric surgeries in group I and 630 surgeries in group II. In group I, most surgeries were performed by general surgeons (GS, 37.5%) and urologists (GU, 35.9%), while a smaller portion were performed by otolaryngologists (ENT, 10.7%) and plastic surgeons (PLS, 7.4%). Gynecologists or colorectal, cardiovascular and orthopedic surgeons performed <5% of surgeries. In group II, a majority of operations were performed by a PS (54.4%), and significantly fewer surgeries were performed by GS (p < 0.05); a significantly greater number were performed by PLS (p < 0.05). A pediatric surgeon performed a greater number of all types of surgeries in group II compared to group I, with the exception of orchiopexies and anal fistulectomy. In group I, although many different types of surgeries could have been performed, none were commonly performed by a PS.ConclusionThe total number of surgeries apparently increased after the participation of a PS. Surgical operations performed by GS decreased significantly and were not affected by GU, ENT or PLS. Results from this study illustrate the importance of having PS in regional hospitals and emphasize the need for surgeons with subspecialty training. The need is especially high and complementary to other surgical subspecialists in regional hospitals.