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柬埔寨获取耳科和听力保健服务的差距:一项基于患者体验的混合方法研究。

Disparities in access to ear and hearing care in Cambodia: a mixed methods study on patient experiences.

机构信息

Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia.

Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia.

出版信息

J Laryngol Otol. 2023 Apr;137(4):373-389. doi: 10.1017/S0022215122001396. Epub 2022 Jun 14.

Abstract

OBJECTIVE

Chronic suppurative otitis media is a major global disease disproportionately affecting low- and middle-income countries, but few studies have explored access to care for those with ear and hearing disorders.

METHOD

In a tertiary hospital in Cambodia providing specialist ear services, a mixed method study was undertaken. This study had three arms: (1) quantitative analysis of patients undergoing ear surgery, (2) a questionnaire survey and (3) semi-structured in-depth interviews.

RESULTS

Patients presented with advanced middle-ear disease and associated hearing loss at rates that are amongst the highest per capita levels globally. Patients reported several structural, financial and socio-cultural barriers to treatment. This study showed a significant burden of ear disease in Cambodia, which reflects a delay in receiving timely and effective treatment.

CONCLUSION

This study highlights the opportunity to integrate effective ear and hearing care into primary care service provision, strengthening the package of activities delivered at government facilities.

摘要

目的

慢性化脓性中耳炎是一种在全球范围内发病率较高的疾病,尤其在中低收入国家更为普遍,但针对该疾病患者的医疗服务可及性问题,仅有少数研究进行了探索。

方法

在柬埔寨一家提供专科耳部服务的三级医院中,进行了一项混合方法研究。该研究有三个部分:(1)接受耳部手术患者的定量分析,(2)问卷调查,以及(3)半结构式深入访谈。

结果

患者的中耳疾病和相关听力损失程度较为严重,发病率处于全球最高水平之列。患者报告了在治疗过程中存在多种结构、经济和社会文化方面的障碍。本研究表明柬埔寨耳部疾病负担沉重,这反映出患者在获得及时和有效的治疗方面存在延误。

结论

本研究强调了将有效的耳部和听力保健服务纳入初级保健服务提供的机会,以加强政府医疗机构提供的各项活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a66d/10040287/5caaccf0bc4f/S0022215122001396_fig1.jpg

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