Esquivel Micaela M, Chen Joy C, Woo Russell K, Siegler Nora, Maldonado-Sifuentes Francisco A, Carlos-Ochoa Jehidy S, Cardona-Diaz Andy R, Uribe-Leitz Tarsicio, Siegler Dennis, Weiser Thomas G, Yang George P
Department of Surgery, Stanford University, Stanford, California.
Kapiolani Medical Center for Women and Children, Honolulu, Hawaii; Department of Surgery, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii.
J Surg Res. 2017 Jul;215:160-166. doi: 10.1016/j.jss.2017.03.056. Epub 2017 Apr 6.
Hospital de la Familia was established to serve the indigent population in the western highlands of Guatemala and has a full-time staff of Guatemalan primary care providers supplemented by short-term missions of surgical specialists. The reasons for patients seeking surgical care in this setting, as opposed to more consistent care from local institutions, are unclear. We sought to better understand motivations of patients seeking mission-based surgical care.
Patients presenting to the obstetric and gynecologic, plastic, ophthalmologic, general, and pediatric surgical clinics at the Hospital de la Familia from July 27 to August 6, 2015 were surveyed. The surveys assessed patient demographics, surgical diagnosis, location of home, mode of travel, and reasons for seeking care at this facility.
Of 252 patients surveyed, 144 (59.3%) were female. Most patients reported no other medical condition (67.9%, n = 169) and no consistent income (83.9%, n = 209). Almost half (44.9%, n = 109) traveled >50 km to receive care. The most common reasons for choosing care at this facility were reputation of high quality (51.8%, n = 130) and affordability (42.6%, n = 102); the least common reason was a lack of other options (6.4%, n = 16).
Despite long travel distances and the availability of other options, reputation and affordability were primarily cited as the most common reasons for choosing to receive care at this short-term surgical mission site. Our results highlight that although other surgical options may be closer and more readily available, reputation and cost play a large role in choice of patients seeking care.
“家庭医院”是为危地马拉西部高地的贫困人口服务而设立的，其全职员工为危地马拉初级医疗服务提供者，此外还有外科专家的短期任务。与从当地机构获得更持续的医疗服务相比，患者在此寻求手术治疗的原因尚不清楚。我们试图更好地了解寻求基于任务的手术治疗的患者的动机。
对2015年7月27日至8月6日在“家庭医院”的妇产科、整形科、眼科、普通外科和小儿外科诊所就诊的患者进行了调查。调查评估了患者的人口统计学特征、手术诊断、家庭住址、出行方式以及在此机构寻求治疗的原因。
在接受调查的252名患者中，144名（59.3%）为女性。大多数患者报告没有其他疾病（67.9%，n = 169）且没有稳定收入（83.9%，n = 209）。几乎一半（44.9%，n = 109）的患者前往超过50公里的地方接受治疗。选择在此机构接受治疗的最常见原因是高质量的声誉（51.8% , n = 130）和可承受性（42.6% , n = 102）；最不常见的原因是没有其他选择（6.4% , n = 16）。
尽管路途遥远且有其他选择，但声誉和可承受性主要被认为是选择在这个短期手术任务地点接受治疗的最常见原因。我们的结果表明，虽然其他手术选择可能更近且更容易获得，但声誉和成本在寻求治疗的患者选择中起着很大作用。
