Pearson Catherine A, Stevens Michael P, Sanogo Kakotan, Bearman Gonzalo M L
School of Medicine, Virginia Commonwealth University, Richmond, VA 23298, USA.
Int J Family Med. 2012;2012:298472. doi: 10.1155/2012/298472. Epub 2012 Jun 19.
Objective. The aim of this study is to describe and compare access and barriers to health services in three proximal yet topographically distinct communities in northern Honduras served by the nonprofit organization the Honduras Outreach Medical Brigada Relief Effort (HOMBRE). Methods. Study personnel employed a 25-item questionnaire in Spanish at the point of care during HOMBRE clinics in Coyoles, Lomitas, and La Hicaca (N = 220). We describe and compare the responses between sites, using Chi-squared and Fisher Exact tests. Results. Respondents in Lomitas demonstrated the greatest limitations in access and greatest barriers to care of all sites. Major limitations in access included "never" being able to obtain a blood test, obtain radiology services, and see a specialist. Major barriers were cost, distance, facility overcrowding, transportation, being too ill to go, inability to take time off work, and lack of alternate childcare. Conclusions. Despite being under the same local health authority, geographically remote Honduran communities experience greater burdens in healthcare access and barriers than neighboring communities of the same region.
目的。本研究旨在描述和比较洪都拉斯北部三个地理位置相近但地形不同的社区在获得医疗服务方面的情况及障碍,这些社区由非营利组织洪都拉斯外展医疗旅救援行动(HOMBRE)提供服务。方法。研究人员在科约莱斯、洛米塔斯和拉伊卡卡的HOMBRE诊所就诊时,用西班牙语对220名患者进行了一项包含25个项目的问卷调查。我们使用卡方检验和费舍尔精确检验来描述和比较各地点之间的回答。结果。在所有地点中,洛米塔斯的受访者在获得医疗服务方面表现出最大的限制和最大的就医障碍。获得医疗服务的主要限制包括“从未”能够进行血液检测、获得放射学服务以及看专科医生。主要障碍包括费用、距离、医疗机构拥挤、交通、病情太重无法前往、无法请假以及缺乏替代的儿童照料。结论。尽管处于同一个地方卫生当局管辖之下,但地理位置偏远的洪都拉斯社区在获得医疗服务方面比同一地区的邻近社区面临更大的负担和障碍。