Matthew D Price1,2, Haadi T Shalabi3,4,5, Blasco Guzhñay3, Saggah T Shalabi5, Raymond R Price6,7, Edgar B Rodas3,8. 1. University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT, 84132, USA. matthew.dean.price@gmail.com. 2. Cinterandes Foundation, Cuenca, Ecuador. matthew.dean.price@gmail.com. 3. Cinterandes Foundation, Cuenca, Ecuador. 4. University of Nottingham, Nottingham, UK. 5. Gold Coast University Hospital, Southport, QLD, Australia. 6. Intermountain Health Care, Salt Lake City, UT, USA. 7. University of Utah Center for Global Surgery, Salt Lake City, UT, USA. 8. VCU Division of Acute Care Services, Richmond, VA, USA.
Abstract
BACKGROUND: An estimated 5 billion people worldwide lack access to timely safe surgical care (Gawande in Lancet 386(9993):523-525, 2015). A mere 6% of all surgical procedures occur in the poorest countries where over a third of the world's population lives (Meara et al. in Surgery 158(1):3-6, 2015). Mobile surgical units like the Cinterandes Foundation endeavor to bring surgical care directly to these communities who otherwise would lack access to safe surgery. This study examines the barriers patients encounter in seeking surgical care in rural communities of Ecuador and their impressions on how mobile surgery addresses such barriers. METHODS: Open interviews were conducted with Cinterandes' patients who had undergone an operation in the mobile surgical unit between 06/25/2013 and 06/25/2014 (n = 101). Interviews were structured to explore two main domains: (1) examining barriers patients have in accessing surgery, (2) assessing patients' opinion of how mobile surgery helped in overcoming such barriers. RESULTS: Patient inconvenience (70%), cost (21%), and lack of trust in local hospitals (24%) were the main cited barriers to surgical access. Increased patient convenience (53%), cheaper surgical care (34%), and trust in Cinterandes (47%) were the main cited benefits to mobile surgery. CONCLUSION: Mobile surgery provided by Cinterandes effectively overcomes many barriers patients encounter when seeking surgical care in rural Ecuador: decreased patient wait times, limited number of referrals to multiple locations, and decreased cost. Partnering with local clinics within the communities and bringing care much closer to patients' homes may provide a better patient friendly health care delivery system for rural Ecuador.
BACKGROUND: An estimated 5 billion people worldwide lack access to timely safe surgical care (Gawande in Lancet 386(9993):523-525, 2015). A mere 6% of all surgical procedures occur in the poorest countries where over a third of the world's population lives (Meara et al. in Surgery 158(1):3-6, 2015). Mobile surgical units like the Cinterandes Foundation endeavor to bring surgical care directly to these communities who otherwise would lack access to safe surgery. This study examines the barriers patients encounter in seeking surgical care in rural communities of Ecuador and their impressions on how mobile surgery addresses such barriers. METHODS: Open interviews were conducted with Cinterandes' patients who had undergone an operation in the mobile surgical unit between 06/25/2013 and 06/25/2014 (n = 101). Interviews were structured to explore two main domains: (1) examining barriers patients have in accessing surgery, (2) assessing patients' opinion of how mobile surgery helped in overcoming such barriers. RESULTS:Patient inconvenience (70%), cost (21%), and lack of trust in local hospitals (24%) were the main cited barriers to surgical access. Increased patient convenience (53%), cheaper surgical care (34%), and trust in Cinterandes (47%) were the main cited benefits to mobile surgery. CONCLUSION: Mobile surgery provided by Cinterandes effectively overcomes many barriers patients encounter when seeking surgical care in rural Ecuador: decreased patient wait times, limited number of referrals to multiple locations, and decreased cost. Partnering with local clinics within the communities and bringing care much closer to patients' homes may provide a better patient friendly health care delivery system for rural Ecuador.
Entities:
Keywords:
Barrier Patient; Local Healthcare System; Local Hospital; Operate Room Nurse; Patient Wait Time
Authors: H T Shalabi; M D Price; S T Shalabi; E B Rodas; A L Vicuña; B Guzhñay; R R Price; E Rodas Journal: Surg Endosc Date: 2017-06-21 Impact factor: 4.584
Authors: John G Meara; Andrew J M Leather; Lars Hagander; Blake C Alkire; Nivaldo Alonso; Emmanuel A Ameh; Stephen W Bickler; Lesong Conteh; Anna J Dare; Justine Davies; Eunice Dérivois Mérisier; Shenaaz El-Halabi; Paul E Farmer; Atul Gawande; Rowan Gillies; Sarah L M Greenberg; Caris E Grimes; Russell L Gruen; Edna Adan Ismail; Thaim Buya Kamara; Chris Lavy; Lundeg Ganbold; Nyengo C Mkandawire; Nakul P Raykar; Johanna N Riesel; Edgar Rodas; John Rose; Nobhojit Roy; Mark G Shrime; Richard Sullivan; Stéphane Verguet; David Watters; Thomas G Weiser; Iain H Wilson; Gavin Yamey; Winnie Yip Journal: Surgery Date: 2015-05-16 Impact factor: 3.982
Authors: Charles R Doarn; Sara Fitzgerald; Edgar Rodas; Brett Harnett; Anita Prabe-Egge; Ronald C Merrell Journal: Telemed J E Health Date: 2002 Impact factor: 3.536