Share of the population at risk of catastrophic spending when surgical care is required

The proportion of population at risk of catastrophic expenditure when surgical care is required. Catastrophic expenditure is defined as direct out of pocket payments for surgical and anaesthesia care exceeding 10% of total income.

Aggregation method:

Weighted average

Statistical concept and methodology:

Methodology: The probability of experiencing impoverishment when surgical care is required and the probability of experiencing catastrophic expenditure (10 percent of total income) when surgical care is required. Statistical concept(s): The Lancet Commission on Global Surgery, assembled in 2013 to assess surgical care around the world. Commissioners engaged in an iterative global consultative process with partners in over 110 countries to develop six core indicators of the strength of a surgical system. Two indicators assess a country’s preparedness to deliver safe surgery and anesthesia, two assess the current delivery of safe care, and two assess the state of financial risk protection for those seeking surgery.

Development relevance:

Billions people lack access to safe and affordable surgical, anesthesia and obstetric (SAO) care while a third of the global burden of disease requires surgical and/or anesthesia decision-making or treatment. Treating the sick very often requires surgery and anesthesia. Despite such huge burden of disease, safe and affordable SAO care is often overlooked.

Limitations and exceptions:

Prior to 2015, global data on surgery, anesthesia and obstetric care was virtually nonexistent. With the idea that “We can’t manage what we don’t measure”, the Lancet Commission on Global Surgery developed six Surgical, Obstetric and Anesthesia (SAO) indicators and collected data for them. The analysis of these data show large gaps in SAO care across countries by income groups.