Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts.
School of Medicine, Washington University, St. Louis, Missouri.
J Surg Res. 2019 Aug;240:175-181. doi: 10.1016/j.jss.2019.03.007. Epub 2019 Apr 4.
Lebanon hosts an estimated one million Syrian refugees registered with the United Nations High Commissioner for Refugees (UNHCR). The UNHCR contracts with select Lebanese hospitals to provide affordable primary and emergency care to refugees. We aimed to assess the surgical capabilities of UNHCR-affiliated hospitals in Lebanon.
Cross-sectional data from the Surgical Capacity in Areas with Refugees study were combined with hospital affiliation data obtained from the UNHCR. The Surgical Capacity in Areas with Refugees study evaluated surgical capacity in Lebanon by mapping all acute care hospitals and administering the five domain Personnel, Infrastructure, Procedures, Equipment, and Supplies (PIPES) tool to each hospital. Mean PIPES indices and mean numbers of hospital beds, surgeons, and anesthesiologists were compared between UNHCR-affiliated and nonaffiliated hospitals. Geographically, the distribution of UNHCR-affiliated hospitals was cross-referenced with refugee population distributions.
One hundred and twenty nine hospitals were included, 35 (27.1%) of which were affiliated with the UNHCR. The PIPES tool was administered across all hospitals. Mean PIPES indices and mean number of hospital beds, general surgeons, and anesthesiologists were similar between UNHCR-affiliated and nonaffiliated hospitals. Geographical mapping of hospitals and refugee populations across Lebanon revealed a disparity in the Northeastern region of the country: that region had the highest number of refugees but lacked sufficient UNHCR coverage.
Hospitals covered by the UNHCR performed similarly to nonaffiliated hospitals with respect to all aspects of the PIPES surgical capacity tool. However, there is a concerning geographic mismatch between UNHCR coverage and refugee density, specifically in the governorates of Akkar, Bekaa, and Baalbek-Hermel.
黎巴嫩接纳了约 100 万在联合国难民署（UNHCR）登记的叙利亚难民。UNHCR 与一些黎巴嫩医院签订合同，为难民提供负担得起的基本医疗和急诊服务。我们旨在评估黎巴嫩 UNHCR 附属医院的外科能力。
将来自“难民地区外科能力”研究的横断面数据与从 UNHCR 获得的医院附属关系数据相结合。“难民地区外科能力”研究通过绘制所有急性护理医院地图并对每家医院进行五个领域（人员、基础设施、程序、设备和供应品）工具的评估，评估了黎巴嫩的外科能力。比较了 UNHCR 附属和非附属医院的 PIPES 指数均值和医院床位、外科医生和麻醉师的平均数量。在地理上，UNHCR 附属医院的分布与难民人口分布进行了交叉参考。
共纳入 129 家医院，其中 35 家（27.1%）与 UNHCR 有关联。对所有医院都进行了 PIPES 工具的管理。UNHCR 附属和非附属医院的 PIPES 指数均值和医院床位、普通外科医生和麻醉师的平均数量相似。黎巴嫩全国医院和难民人口的地理映射显示该国东北部地区存在差异：该地区拥有最多的难民，但缺乏足够的 UNHCR 覆盖。
就 PIPES 外科能力工具的所有方面而言，UNHCR 覆盖的医院与非附属医院的表现相似。然而，UNHCR 覆盖范围和难民密度之间存在令人担忧的地理不匹配，特别是在阿卡、贝卡和巴尔贝克-赫尔梅尔省。
