Center for Global Surgery, University of Utah Health, Salt Lake City, Utah, USA.
General Surgery, University of Utah Hospital, Salt Lake City, Utah, USA.
BMJ Open. 2021 Nov 25;11(11):e051122. doi: 10.1136/bmjopen-2021-051122.
Define the services available for the care of breast cancer at hospitals in the Eastern Region of Ghana, identify areas of the region with limited access to care through geospatial mapping, and test a novel survey instrument in anticipation of a nationwide scale up of the study.
A cross-sectional, facility-based survey study.
This study was conducted at 33 of the 34 hospitals in the Eastern Region of Ghana from March 2020 to May 2020.
The 33 hospitals surveyed represented 97% of all hospitals in the region. This included private, government, quasi-government and faith-based organisation owned hospitals.
Sixteen hospitals (82%) surveyed provided basic screening services, 11 (33%) provided pathological diagnosis and 3 (9%) provided those services in addition to basic surgical care.53%, 64% and 78% of the population lived within 10 km, 25 km and 45 km of screening, diagnostic and treatment services respectively. Limited chemotherapy was available at two hospitals (6%), endocrine therapy at one hospital (3%) and radiotherapy was not available. Twenty-nine hospitals (88%) employed a general practitioner and 13 (39%) employed a surgeon. Oncology specialists, pathology personnel and a plastic surgeon were only available in one hospital (3%) in the Eastern Region.
Although 16 hospitals (82%) provided screening, only half the population lived within reasonable distance of these services. Few hospitals offered diagnosis and surgical services, but 64% and 78% of the population lived within a reasonable distance of these hospitals. Geospatial analysis suggested two priorities to cost-effectively expand breast cancer services: (1) increase the number of health facilities providing screening services and (2) centralise basic imaging, pathological and surgical services at targeted hospitals.
确定加纳东部地区医院提供的乳腺癌护理服务，通过地理空间映射确定该地区服务覆盖有限的区域，并测试一种新的调查工具，为全国范围内的研究扩展做准备。
这是一项横断面、基于机构的调查研究。
本研究于 2020 年 3 月至 2020 年 5 月在加纳东部地区的 33 家医院进行。
接受调查的 33 家医院代表该地区所有医院的 97%。这包括私人、政府、准政府和信仰组织拥有的医院。
接受调查的 16 家（82%）医院提供基本筛查服务，11 家（33%）提供病理诊断，3 家（9%）除了基本手术护理外还提供这些服务。53%、64%和 78%的人口居住在距离筛查、诊断和治疗服务 10 公里、25 公里和 45 公里以内。两家医院（6%）提供有限的化疗，一家医院（3%）提供内分泌治疗，没有放疗。29 家（88%）医院雇用了全科医生，13 家（39%）医院雇用了外科医生。肿瘤专家、病理人员和整形外科医生仅在东部地区的一家医院（3%）有提供。
尽管有 16 家（82%）医院提供筛查服务，但只有一半的人口居住在合理的服务范围内。很少有医院提供诊断和手术服务，但 64%和 78%的人口居住在这些医院的合理范围内。地理空间分析表明，有两个重点可以有效地扩大乳腺癌服务：（1）增加提供筛查服务的卫生机构数量；（2）在目标医院集中基本成像、病理和手术服务。
