Michelle L Faierman1, Jamie E Anderson2, Americo Assane3, Peter Bendix4, Fernando Vaz3, John A Rose5, Carlos Funzamo3, Stephen W Bickler5, Emilia V Noormahomed6. 1. The Ohio State University College of Medicine, 370 W. 9th Ave., Columbus, OH 43210, USA. 2. University of California, San Diego, Department of Surgery, 200 W. Arbor Drive, San Diego, CA 92103, USA jaa002@ucsd.edu. 3. Universidade Eduardo Mondlane, Maputo, Mozambique. 4. Dartmouth-Hitchcock Medical Center, Department of Surgery, 1 Medical Center Drive, Lebanon, NH 03756, USA. 5. University of California, San Diego, Department of Surgery, 200 W. Arbor Drive, San Diego, CA 92103, USA. 6. Universidade Eduardo Mondlane, Maputo, Mozambique University of California, San Diego, Department of Medicine, 9500 Gilman Drive, San Diego, CA 92093, USA.
Abstract
BACKGROUND: Surgical care is increasingly recognised as an important component of global health delivery. However, there are still major gaps in knowledge related to access to surgical care in low-income countries. In this study, we compare distances travelled by surgical patients with patients seeking other medical services at a first-level hospital in rural Mozambique. METHODS: Data were collected on all inpatients at Hospital Rural de Chókwè in rural Mozambique between 20 June 2012 and 3 August 2012. Euclidean distances travelled by surgical versus non-surgical patients using coordinates of each patient's city of residence were compared. Data were analysed using ArcGIS 10 and STATA. RESULTS: In total, 500 patients were included. Almost one-half (47.6%) lived in the city where the hospital is based. By hospital ward, the majority (62.0%) of maternity patients came from within the hospital's city compared with only 35.2% of surgical patients. The average distance travelled was longest for surgical patients (42 km) compared with an average of 17 km for patients on all other wards. CONCLUSIONS: Patients seeking surgical care at this first-level hospital travel farther than patients seeking other services. While other patients may have access to at community clinics, surgical patients depend more heavily on the services available at first-level hospitals.
BACKGROUND: Surgical care is increasingly recognised as an important component of global health delivery. However, there are still major gaps in knowledge related to access to surgical care in low-income countries. In this study, we compare distances travelled by surgical patients with patients seeking other medical services at a first-level hospital in rural Mozambique. METHODS: Data were collected on all inpatients at Hospital Rural de Chókwè in rural Mozambique between 20 June 2012 and 3 August 2012. Euclidean distances travelled by surgical versus non-surgical patients using coordinates of each patient's city of residence were compared. Data were analysed using ArcGIS 10 and STATA. RESULTS: In total, 500 patients were included. Almost one-half (47.6%) lived in the city where the hospital is based. By hospital ward, the majority (62.0%) of maternity patients came from within the hospital's city compared with only 35.2% of surgical patients. The average distance travelled was longest for surgical patients (42 km) compared with an average of 17 km for patients on all other wards. CONCLUSIONS:Patients seeking surgical care at this first-level hospital travel farther than patients seeking other services. While other patients may have access to at community clinics, surgical patients depend more heavily on the services available at first-level hospitals.
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