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Eugene Vayda, MD, FRCP(C); William R. Mindell, MPH; Ira M. Rutkow, MD, MPH, DrPH

Arch Surg. 1982;117(6):846-853.

Abstract
• Between 1966 and 1976, overall surgical rates in Canada remained relatively unchanged and consistently 60% higher than those in England and Wales. Overall United States rates were the highest of the three countries and increased 25% over the ten years. Numbers of surgeons per capita increased in both Canada and England and Wales but overall surgical rates in the two countries did not; in the United States both surgeons and operative rates increased. During the decade, Canada had more hospital beds per capita than the United States while England and Wales had the fewest. Since 1970, the percentage of gross national product spent on health care has been greatest in the United States, intermediate in Canada, and lowest in England and Wales. These expenditures may better reflect national priorities and values and, thus, be more important than per capita numbers of hospital beds or surgeons in explaining the cross-national difference in rates of surgery.

(Arch Surg 1982;117:846-853)

Author Affiliations
From the Department of Health Administration, Faculty of Medicine, University of Toronto (Dr Vayda and Mr Mindell); and the Departments of Surgery (Dr Rutkow) and Health Services Administration (Dr Rutkow), The Johns Hopkins Medical Institutions, Baltimore. Dr Rutkow is an Edwin L. Crosby Memorial Fellow of the Hospital Research and Educational Trust.

Footnotes
Accepted for publication Aug 12, 1981.

Reprint requests to Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD 21205 (Dr Rutkow).

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