Bax Kevin, Shedda Susan, Frizelle Frank
Department of Surgery, Christchurch Hospital, Christchurch.
N Z Med J. 2006 Jun 23;119(1236):U2025.
Equitable access and provision of healthcare is a cornerstone of New Zealand Government health planning. Recent closures of rural hospitals have lead to difficulties with access to surgical services. The mobile surgical service has been developed to help; partly to address this issue as well as to address several other stated goals in the provision of rural heath. This study aims to audit the goals set out for the mobile surgical service and determine if they are been achieved.
The following outcome measures were assessed: number and type of procedure, length of stay, complications, services for Maori, upskilling for rural staff, social benefits, impact on child health, improved training with telepresence surgery, and the cost.
Over the first 2 years (1 March 2002 to 28 February 2004) of service provision, 1901 procedures were undertaken; 57 patients had complications. The most common complication was wound infection, which occurred in 5% of operations. One in 3 treated patients were Maori and 40% of those treated were 15 years of age or younger. The mobile surgical bus service also appears to be meeting its social benefit, upskilling goals, and educational goals.
The provision of specialist services to the rural communities is a difficult problem faced not only in New Zealand. Though still on a trial basis, the mobile surgical service bus appears to be meeting its stated goals to be addressing one of the important goals of the Government health policy: equitable access and provision to surgical care.
公平获得和提供医疗保健是新西兰政府卫生规划的基石。最近农村医院的关闭导致获得外科手术服务出现困难。移动外科服务应运而生,部分原因是为了解决这一问题,同时也是为了实现农村医疗保健提供方面的其他几个既定目标。本研究旨在审核为移动外科服务设定的目标,并确定这些目标是否得以实现。
评估了以下结果指标:手术数量和类型、住院时间、并发症、为毛利人提供的服务、农村工作人员技能提升、社会效益、对儿童健康的影响、远程手术培训改进情况以及成本。
在服务提供的头两年(2002年3月1日至2004年2月28日),共进行了1901例手术;57例患者出现并发症。最常见的并发症是伤口感染,发生率为5%。每3名接受治疗的患者中有1名是毛利人,40%的接受治疗者年龄在15岁及以下。移动外科巴士服务似乎也在实现其社会效益、技能提升目标和教育目标。
为农村社区提供专科服务不仅是新西兰面临的难题。尽管仍处于试验阶段,但移动外科服务巴士似乎正在实现其既定目标,即解决政府卫生政策的一个重要目标:公平获得和提供外科护理。