Hospital Volume of Work in Syria:
We adopted several methods to estimate the volume of work in the services provided by the hospital.
1. Number of patients visiting emergency department and outpatient departments, in addition to, the number of emergency and non-emergency admissions.
2. The number of surgical procedures according to the specialties.
An inquiry was made about the availability of detailed medical records at the hospitals. In the hospitals that had detailed medical records, the number of trauma and non-trauma cases, and emergency and non-emergency cases were recorded.
In hospitals that did not maintain detailed medical records, the total number of surgeries were recorded based on available specialties.
In general, 60% hospitals had detailed medical records, while 40% were lacking such records. However, this result was widely variable among the different governorates as shown in this figure:
The figure above represents the availability of acceptable hospital records during the month of August 2015. However, to be able to come up with average percentages, these figures should be compared with the data, we compiled through UOSSM surgical electronic coding system for the last 2 years supported by our monthly visits to the hospitals. This electronic coding system that is currently in place, weighs only trauma-related surgeries. We will be working on expanding the electronic coding system to include all types of surgeries.
- Hospitals that had abridged patient medical records
- Highest numbers of procedures were recorded in general and orthopedic surgeries
- Lack of oncology and pediatric surgical records were noted, due to lack of specialists
- Number of reconstructive surgeries did not match the expected number if compared to the high volume of complex orthopedic cases
- There were no real cardiac surgery medical records and no elective cardiac surgery records, due to lack of specialists
Hospitals that had detailed patient medical records:
The following table provides an overall idea of the diversity of surgeries and their numbers in hospitals that provided details of their procedures (a more profound study and analysis of the figures at different provincial levels should be conducted).
The number of hospital normal deliveries was integrated with the number of caesarean sections (C-sections) as follows:
High rates of Caesarean sections were noted, accounting for almost one third of hospital deliveries. However, this figure doesn’t reflect the real number of deliveries, as many births occur outside the hospitals and clinics, in homes by midwives.