Trends and Regional Disparities of Cardiothoracic Anesthesia Procedures in China Between 2016 and 2023

Abstract

Purpose

This study quantified trends and regional disparities in cardiothoracic anesthesia procedures across China from 2016 to 2023, assessing workforce adequacy to inform policy development.

Methods

Data were extracted from the White Book of Chinese Cardiovascular Surgery and standardized monthly reports of the Chinese Society of Cardiothoracic and Vascular Anesthesiology (CSCTVA). Cardiac anesthesia volumes reflected national aggregates, while thoracic anesthesia data derived from 100 CSCTVA member hospitals. Regional economic stratification (GDP tiers) and workforce surveys from top-tier centers complemented procedural analyses.

Results

Cardiac anesthesia procedures increased by 25% (2016: 158,268 and 2023: 197,937), with cardiopulmonary bypass utilization growing at 13.3% CAGR. Thoracic anesthesia volumes tripled from 114 460 in 2016 to 301 412 in 2023, coinciding with a rise in minimally invasive techniques from 67% to 91.4% of all procedures. Significant regional disparities emerged: High-GDP regions exhibited fivefold greater thoracic surgery density (52.26 vs 10.56 per 100 000; P < .01). Top 10 centers performed 32%–42% of thoracic procedures, yet a 60.5% workforce expansion lagged demand, yielding sub-optimal doctor-patient ratios (e.g., 1:4.7).

Conclusions

Rapid growth in cardiothoracic anesthesia is juxtaposed with persistent geographic inequities and critical workforce shortages. Strategic interventions are urgently needed to ensure equitable access; these findings establish a comprehensive baseline framework for hypothesis-driven research on health system optimization.