Kwame Nkrumah University of Science & Technology, Kumasi, Ghana; Komfo Anokye Teaching Hospital, Kumasi, Ghana.
Non-Communicable Disease Control Program, Public Health Division, Ghana Health Service, Accra, Ghana.
J Neurol Sci. 2022 Jun 15;437:120250. doi: 10.1016/j.jns.2022.120250. Epub 2022 Apr 6.
Data on utilization of outpatient departments (OPD) within a country is one strategic approach to gain nationwide and regional insights into the frequency of and types of health facilities where patients seek healthcare. In particular, such data could be used to develop quality improvement interventions in sub-Saharan Africa where the burden of stroke is high but outcomes are relatively poor.
To evaluate the characteristics of out-patient clinic visits by stroke survivors in Ghana by geo-ecological region (state) and by type of health facilities.
We conducted a retrospective analysis of prospectively collected data from 2019 to 2021 via the District Health Information System (DHIMS2) platform of the Ghana Health Service. Rates of stroke OPD encounters were expressed as number of visits by stroke survivors divided by number of OPD visits in a healthcare facility per 100,000 visits.
Across, 9309 health facilities, there were 23,074 stroke OPD encounters in 2019, 19,485 in 2020 and 20,333 in 2021. Rates of stroke OPD visits were 109.2/100,000 visits population in 2019, 96.5/100,000 visits in 2020 and 99.7/100,000 visits in 2021. The highest rates of stroke OPD visits occurred in the middle-belt regions over the study period perhaps reflecting the distribution of the national stroke burden. Nearly 75% of all stroke OPD visits occurred at a primary level, 17% at secondary- level, and 8% at tertiary-level health facilities.
The middle geo-ecological belt has the highest rate of stroke OPD attendance in Ghana with nearly 3 out of 4 stroke patients seeking healthcare at a primary health care (PHC) facility. There is therefore a need to build human and infrastructural capacity at the lower cadres of healthcare delivery to optimally address stroke care delivery in these settings.
利用一个国家的门诊部门（OPD）数据是获得全国和地区范围内了解患者寻求医疗保健的卫生机构频率和类型的一种战略方法。特别是，在中风负担较高但结果相对较差的撒哈拉以南非洲地区，可以利用这些数据来开展质量改进干预措施。
按地理生态区域（州）和卫生机构类型评估加纳中风幸存者的门诊就诊特征。
我们通过加纳卫生服务部的地区卫生信息系统（DHIMS2）平台，对 2019 年至 2021 年期间前瞻性收集的数据进行回顾性分析。门诊就诊率表示中风幸存者就诊次数除以某卫生机构的门诊就诊次数除以每 10 万次就诊的人数。
在 9309 个卫生机构中，2019 年有 23074 次中风门诊就诊，2020 年有 19485 次，2021 年有 20333 次。2019 年中风门诊就诊率为 109.2/10 万就诊人口，2020 年为 96.5/10 万就诊，2021 年为 99.7/10 万就诊。在研究期间，中地带地区的中风门诊就诊率最高，这可能反映了国家中风负担的分布。近 75%的中风门诊就诊发生在初级卫生保健机构，17%发生在二级卫生保健机构，8%发生在三级卫生保健机构。
加纳中部地理生态带的中风门诊就诊率最高，近 3/4 的中风患者在初级卫生保健（PHC）机构寻求医疗保健。因此，需要在医疗保健提供的较低职级建立人力和基础设施能力，以在这些环境中优化中风护理的提供。
