BACKGROUND Indicators to evaluate progress towards timely access to safe surgical, anaesthesia, and obstetric (SAO) care were proposed in 2015 by the Lancet Commission on Global Surgery. These aimed to capture access to surgery, surgical workforce, surgical volume, perioperative mortality rate, and catastrophic and impoverishing financial consequences of surgery. Despite being rapidly taken up by practitioners, data points from which to derive the indicators were not defined, limiting comparability across time or settings. We convened global experts to evaluate and explicitly define-for the first time-the indicators to improve comparability and support achievement of 2030 goals to improve access to safe affordable surgical and anaesthesia care globally. METHODS AND FINDINGS The Utstein process for developing and reporting guidelines through a consensus building process was followed. In-person discussions at a 2-day meeting were followed by an iterative process conducted by email and virtual group meetings until consensus was reached. The meeting was held between June 16 to 18, 2019; discussions continued until August 2020. Participants consisted of experts in surgery, anaesthesia, and obstetric care, data science, and health indicators from high-, middle-, and low-income countries. Considering each of the 6 indicators in turn, we refined overarching descriptions and agreed upon data points needed for construction of each indicator at current time (basic data points), and as each evolves over 2 to 5 (intermediate) and >5 year (full) time frames. We removed one of the original 6 indicators (one of 2 financial risk protection indicators was eliminated) and refined descriptions and defined data points required to construct the 5 remaining indicators: geospatial access, workforce, surgical volume, perioperative mortality, and catastrophic expenditure. A strength of the process was the number of people from global institutes and multilateral agencies involved in the collection and reporting of global health metrics; a limitation was the limited number of participants from low- or middle-income countries-who only made up 21% of the total attendees. CONCLUSIONS To track global progress towards timely access to quality SAO care, these indicators-at the basic level-should be implemented universally as soon as possible. Intermediate and full indicator sets should be achieved by all countries over time. Meanwhile, these evolutions can assist in the short term in developing national surgical plans and collecting more detailed data for research studies.

中文翻译：

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全球外科、产科和麻醉指标定义和报告：Utstein 共识报告。

背景 柳叶刀全球外科委员会于 2015 年提出了评估及时获得安全手术、麻醉和产科 (SAO) 护理进展情况的指标。这些旨在捕捉手术机会、手术人员、手术量、围手术期死亡率以及手术的灾难性和贫困化财务后果。尽管从业人员迅速采用，但没有定义从中得出指标的数据点，这限制了跨时间或跨环境的可比性。我们召集全球专家评估并首次明确定义指标，以提高可比性并支持实现 2030 年目标，以改善全球范围内获得安全且负担得起的手术和麻醉护理。方法和结果 遵循 Utstein 过程，通过建立共识过程制定和报告指南。在为期 2 天的会议上进行面对面讨论之后，通过电子邮件和虚拟小组会议进行迭代过程，直到达成共识。会议于2019年6月16日至18日举行；讨论一直持续到 2020 年 8 月。参与者包括来自高、中、低收入国家的外科、麻醉和产科护理、数据科学和健康指标方面的专家。依次考虑 6 个指标中的每一个，我们完善了总体描述并就当前构建每个指标所需的数据点（基本数据点）达成一致，并且随着每个指标在 2 到 5 年（中期）和 > 5 年（完整) 时间范围。我们删除了最初的 6 个指标之一（删除了 2 个金融风险保护指标之一），并细化了构建其余 5 个指标所需的描述和定义的数据点：地理空间访问、劳动力、手术量、围手术期死亡率和灾难性支出。该过程的一个优势是来自全球机构和多边机构参与全球卫生指标收集和报告的人数；一个限制是来自低收入或中等收入国家的参与者数量有限——他们仅占总参与者的 21%。结论 为了跟踪及时获得优质 SAO 护理的全球进展，这些指标 - 在基本层面 - 应尽快普遍实施。随着时间的推移，所有国家都应该实现中间和完整的指标集。同时，这些演变可以在短期内帮助制定国家手术计划并为研究收集更详细的数据。