ArticleBMJ open2022
Establishing a baseline for surgical care in Mongolia: a situational analysis using the six indicators from the Lancet Commission on Global Surgery.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review of the Lancet Commission on Global Surgery indicators with quality assessment of modelled estimates.The British journal of surgery · 2026Pooled it
- Climate, geography and socioeconomic vulnerability and emergency care accessibility in Nepal, 2022: a high-resolution geospatial analysis of inequalities.BMJ global health · 2026Article
- Global Neurosurgery: A Path Forward Through Health System Strengthening.Neurosurgery · 2025Review
- Achieving Surgical, Obstetric, Trauma, and Anesthesia (SOTA) care for all in South Asia.Frontiers in public health · 2024Review
- Estimating access to surgical care: A community centered national household survey from Pakistan.PLOS global public health · 2023Article
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo inform national planning, six indicators posed by the
designAn 11-year retrospective analysis of the Mongolian surgical system using data from the Health Development Center, National Statistics Office and Household Socio-Economic Survey. Access estimates were based on travel time to capable hospitals. Provider density, surgical volume and postoperative mortality were calculated at national and regional levels. Protection against impoverishing and catastrophic expenditures was assessed against standard out-of-pocket expenditure at government hospitals for individual operations.
settingMongolia's 81 public hospitals with surgical capability, including tertiary, secondary and primary/secondary facilities.
participantsAll operative patients in Mongolia's public hospitals, 2006-2016. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were national-level results of the indicators. Secondary outcomes include regional access; surgeons, anaesthesiologists and obstetricians (SAO) density; surgical volume; and perioperative mortality.
resultsIn 2016, 80.1% of the population had 2-hour access to essential surgery, including 60% of those outside the capital. SAO density was 47.4/100 000 population. A coding change increased surgical volume to 5784/100 000 population, and in-hospital mortality decreased from 0.27% to 0.14%. All households were financially protected from caesarean section. Appendectomy carried 99.4% and 98.4% protection, external femur fixation carried 75.4% and 50.7% protection from impoverishing and catastrophic expenditures, respectively. Laparoscopic cholecystectomy carried 42.9% protection from both.
conclusionsMongolia meets national benchmarks for access, provider density, surgical volume and postoperative mortality with notable limitations. Significant disparities exist between regions. Unequal access may be efficiently addressed by strengthening or building key district hospitals in population-dense areas. Increased financial protections are needed for operations involving hardware or technology. Ongoing monitoring and evaluation will support the development of context-specific interventions to improve surgical care in Mongolia.
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