Tariku Yihun, Gerum Tadele, Mekonen Mareshet, Takele Haddis
Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Ethiopia.
Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Surg Res Pract. 2019 Feb 3;2019:5367068. doi: 10.1155/2019/5367068. eCollection 2019.
To improve access to surgical service and to reduce neonatal mortality Ethiopia implemented surgical task shifting to nonphysician surgeons (NPSs). We aim at assessing surgical outcomes between NPSs and physician surgeons working in two hospitals.
We collected data from two hospitals on 474 maternal medical records. Completed maternal medical records were included in this study. Data were entered into Epi Info version 7 and analyzed by SPSS version 20 software. Both descriptive and inferential statistics were done. If the 95% confidence interval values exclude the null value, the factor was considered as a significant factor.
Totally, 3429 mothers delivered in two hospitals. Of them, 840 (24.5%) delivered by caesarian section (CS), but 474 mothers' records meet the inclusion criteria included in this study. Of 474 CS deliveries, the majority (82%) of them were performed by NPS. Maternal or fetal emergency conditions were the main reasons (92.0%, =436) for CS. Task shifting does not affect immediate newborn outcomes (ARR, 1.24 (0.55, 2.78)), but duration of hospitalization (ARR: 4 (2.3, 7.5)), condition of the fetus during admission (ARR: 5.22 (2.9, 9.2)), and type of anesthesia used (ARR: 0.2 (0.1, 0.4)) significantly determine the outcome.
Surgical task shifting to NPS does not affect the immediate newborn outcome. But general anesthesia is one of the major factors that affects the outcome.
为了改善外科服务的可及性并降低新生儿死亡率，埃塞俄比亚实施了将手术任务转移给非医师外科医生（NPS）的举措。我们旨在评估在两家医院工作的非医师外科医生和医师外科医生的手术效果。
我们从两家医院收集了474份产妇医疗记录的数据。本研究纳入了完整的产妇医疗记录。数据录入Epi Info 7版本，并使用SPSS 20软件进行分析。进行了描述性和推断性统计分析。如果95%置信区间值不包括零值，则该因素被视为显著因素。
两家医院共有3429名母亲分娩。其中，840例（24.5%）通过剖宫产（CS）分娩，但474名母亲的记录符合本研究纳入标准。在474例剖宫产分娩中，大多数（82%）由非医师外科医生实施。产妇或胎儿紧急情况是剖宫产的主要原因（92.0%，n = 436）。任务转移不影响新生儿即时结局（归因风险比，1.24（0.55，2.78）），但住院时间（归因风险比：4（2.3，7.5））、入院时胎儿状况（归因风险比：5.22（2.9，9.2））和所用麻醉类型（归因风险比：0.2（0.1，0.4））显著决定结局。
将手术任务转移给非医师外科医生不影响新生儿即时结局。但全身麻醉是影响结局的主要因素之一。
