Table 2.
Association between surgical facility standards and performance of other essential procedures
| No. of surgical facilities | Univariable model | Multivariable model | |||
|---|---|---|---|---|---|
| OR | P | OR | P | ||
| Safe surgery equipment | |||||
| ȃNot available | 24 | 1.00 (reference) | 1.00 (reference) | ||
| ȃAvailable | 27 | 1.76 (1.00, 3.11) | 0.049 | 0.89 (0.48, 1.67) | 0.716 |
| Specialist present | |||||
| ȃNo specialist | 28 | 1.00 (reference) | 1.00 (reference) | ||
| ȃSurgeon | 5 | 1.54 (0.69, 3.47) | 0.292 | 2.09 (0.96, 4.53) | 0.062 |
| ȃObstetrician/gynaecologist | 8 | 1.10 (0.56, 2.18) | 0.787 | 0.60 (0.33, 1.09) | 0.093 |
| ȃBoth types of specialist | 10 | 4.62 (2.53, 8.44) | <0.001 | 1.39 (0.71, 2.72) | 0.342 |
| No. of bellwethers | |||||
| ȃ0 | 6 | 1.00 (reference) | 1.00 (reference) | ||
| ȃ1 | 14 | 1.06 (0.48, 2.33) | 0.882 | 0.92 (0.46, 1.81) | 0.798 |
| ȃ2 | 25 | 2.28 (1.11, 4.68) | 0.025 | 1.00 (0.47, 2.09) | 0.989 |
| ȃAll | 6 | 10.35 (4.33, 24.73) | <0.001 | 3.13 (1.28, 7.65) | 0.012 |
| All surgical standards* | |||||
| ȃNot meeting all standards | 48 | 1.00 (reference) | 1.00 (reference) | ||
| ȃMeeting all 3 standards | 3 | 5.23 (1.75, 15.62) | 0.003 | 2.03 (0.91, 4.51) | 0.082 |
| Volume of bellwethers (no. of procedures)† | |||||
| ȃ0–3 | 12 | 1.00 (reference) | 1.00 (reference) | ||
| ȃ4–27 | 13 | 1.51 (0.75, 3.01) | 0.245 | 1.28 (0.68, 2.44) | 0.446 |
| ȃ28–81 | 13 | 2.60 (1.33, 5.11) | 0.005 | 1.15 (0.51, 2.57) | 0.739 |
| ȃ82–535 | 13 | 6.05 (3.11, 11.75) | <0.001 | 1.54 (0.60, 3.91) | 0.370 |
| Caesarean section | |||||
| ȃNot performing | 7 | 1.00 (reference) | 1.00 (reference) | ||
| ȃPerforming | 44 | 1.80 (0.77, 4.19) | 0.176 | 0.71 (0.34, 1.47) | 0.358 |
| Laparotomy | |||||
| ȃNot performing | 19 | 1.00 (reference) | 1.00 (reference) | ||
| ȃPerforming | 32 | 3.33 (1.96, 5.65) | <0.001 | 1.36 (0.77, 2.39) | 0.294 |
| Treatment of open fracture | |||||
| ȃNot performing | 45 | 1.00 (reference) | 1.00 (reference) | ||
| ȃPerforming | 6 | 6.43 (3.25, 12.74) | < 0.001 | 3.16 (1.86, 5.38) | <0.001 |
Values in parentheses are 95% confidence intervals. *Availability of safe surgery equipment, presence of surgeon and obstetrician/gynaecologist, and performance of all three bellwether procedures.†Four-month volume (total number) of the three bellwether procedures.