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Distance to hospital and utilization of surgical services in Haiti: do children, delivering mothers, and patients with emergent surgical conditions experience greater geographical barriers to surgical care?

Friedman, James M.; Hagander, Lars LU ; Hughes, Christopher D.; Nash, Katherine A.; Linden, Allison F.; Blossom, Jeff and Meara, John G. (2013) In International Journal of Health Planning and Management 28(3). p.248-256
Abstract
Background An inverse relationship between healthcare utilization and distance to care has been previously described. The purpose of this study was to evaluate this effect related to emergency and essential surgical care in central Haiti. Methods We conducted a retrospective review of operative logbooks from the Clinique Bon Sauveur in Cange, Haiti, from 2008 to 2010. We used Geographic Information Systems to map the home locations of all patients. Spearman's correlation was used to determine the relationship between surgical utilization and distance, and a multivariate linear regression model identified characteristics associated with differences in distances traveled to care. Results The highest annual surgical utilization rate was 184... (More)
Background An inverse relationship between healthcare utilization and distance to care has been previously described. The purpose of this study was to evaluate this effect related to emergency and essential surgical care in central Haiti. Methods We conducted a retrospective review of operative logbooks from the Clinique Bon Sauveur in Cange, Haiti, from 2008 to 2010. We used Geographic Information Systems to map the home locations of all patients. Spearman's correlation was used to determine the relationship between surgical utilization and distance, and a multivariate linear regression model identified characteristics associated with differences in distances traveled to care. Results The highest annual surgical utilization rate was 184 operations/100 000 inhabitants. We found a significant inverse correlation between surgical utilization rate and distance from residence to hospital (r(s) = -0.68, p = 0.02). The median distance from residence to hospital was 55.9 km. Pediatric patients lived 10.1% closer to the hospital than adults (p<0.01), and distance from residence to hospital was not significantly different between men and women (p = 0.25). Patients who received obstetric or gynecologic surgery originated 7.8% closer to the hospital than patients seeking other operations (p<0.01), and patients who received emergent surgical care originated 24.8% closer to the hospital than patients who received elective surgery (p<0.01). Copyright (C) 2012 John Wiley & Sons, Ltd. Conclusions Utilization of surgical services was low and inversely related to distance from residence to hospital in rural areas of central Haiti. Children and patients receiving obstetric, gynecologic or emergent surgery lived significantly closer to the hospital, and these groups may need special attention to ensure adequate access to surgical care. Copyright (C) 2012 John Wiley & Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Geographic Information Systems, barriers to care, Haiti, surgical, utilization, geographic accessibility
in
International Journal of Health Planning and Management
volume
28
issue
3
pages
248 - 256
publisher
Wiley-Blackwell
external identifiers
  • wos:000322596800006
  • scopus:84881310635
ISSN
1099-1751
DOI
10.1002/hpm.2134
language
English
LU publication?
yes
id
d36e1af5-cd60-4912-ae93-588783675ce9 (old id 4043182)
date added to LUP
2013-10-03 12:14:07
date last changed
2019-02-20 03:22:19
@article{d36e1af5-cd60-4912-ae93-588783675ce9,
  abstract     = {Background An inverse relationship between healthcare utilization and distance to care has been previously described. The purpose of this study was to evaluate this effect related to emergency and essential surgical care in central Haiti. Methods We conducted a retrospective review of operative logbooks from the Clinique Bon Sauveur in Cange, Haiti, from 2008 to 2010. We used Geographic Information Systems to map the home locations of all patients. Spearman's correlation was used to determine the relationship between surgical utilization and distance, and a multivariate linear regression model identified characteristics associated with differences in distances traveled to care. Results The highest annual surgical utilization rate was 184 operations/100 000 inhabitants. We found a significant inverse correlation between surgical utilization rate and distance from residence to hospital (r(s) = -0.68, p = 0.02). The median distance from residence to hospital was 55.9 km. Pediatric patients lived 10.1% closer to the hospital than adults (p&lt;0.01), and distance from residence to hospital was not significantly different between men and women (p = 0.25). Patients who received obstetric or gynecologic surgery originated 7.8% closer to the hospital than patients seeking other operations (p&lt;0.01), and patients who received emergent surgical care originated 24.8% closer to the hospital than patients who received elective surgery (p&lt;0.01). Copyright (C) 2012 John Wiley &amp; Sons, Ltd. Conclusions Utilization of surgical services was low and inversely related to distance from residence to hospital in rural areas of central Haiti. Children and patients receiving obstetric, gynecologic or emergent surgery lived significantly closer to the hospital, and these groups may need special attention to ensure adequate access to surgical care. Copyright (C) 2012 John Wiley &amp; Sons, Ltd.},
  author       = {Friedman, James M. and Hagander, Lars and Hughes, Christopher D. and Nash, Katherine A. and Linden, Allison F. and Blossom, Jeff and Meara, John G.},
  issn         = {1099-1751},
  keyword      = {Geographic Information Systems,barriers to care,Haiti,surgical,utilization,geographic accessibility},
  language     = {eng},
  number       = {3},
  pages        = {248--256},
  publisher    = {Wiley-Blackwell},
  series       = {International Journal of Health Planning and Management},
  title        = {Distance to hospital and utilization of surgical services in Haiti: do children, delivering mothers, and patients with emergent surgical conditions experience greater geographical barriers to surgical care?},
  url          = {http://dx.doi.org/10.1002/hpm.2134},
  volume       = {28},
  year         = {2013},
}