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An attitude scale for evaluating complexity of surgical procedures.

DURING the past three decades, considerable effort has been expended in attempting to establish a criterion for evaluation of surgical operative procedures based on their complexity. This effort resulted primarily from the trend, by general hospitals, to restrict the performance of certain types of surgery to persons considered qualified by training and experience (1). Thus, there was a need to distinguish between the surgical complexity of various operative procedures with respect to both the extent of medical staff privileges granted and the basic requirements for training surgeons (2). More recently, interest has grown in studying surgical complexity for the purpose of developing a tool for evaluating hospital utilization. To conduct these studies, researchers have had to devise methods for evaluation of the surgical complexity of specific operative procedures. Over the years, however, the scientific study of surgical complexity has been seriously handicapped because surgical complexity has been extremely difficult to describe objectively and even more difficult to measure quantitatively. This paper describes my effort to delineate surgical operative procedures based on their complexity.