Buda Alexandra M, Truche Paul, Izquierdo Erick, Izquierdo Sandra de, Asturias Sabrina, Stankey Makela, Park Kee B, Peck Gregory, Juran Sabrina, Evans Faye M
Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
Ministry of Public Health and Social Assistance, Guatemala City, Guatemala.
Lancet Reg Health Am. 2021 Dec 24;7:100145. doi: 10.1016/j.lana.2021.100145. eCollection 2022 Mar.
Two-hour and 30 min travel times to a hospital capable of performing emergency general surgery and cesarean section are benchmarks for timely surgical access. This study aimed to estimate the population of Guatemala with timely access to surgical care and identify existing hospitals where the expansion of surgical services would increase access.
The World Federation of Societies of Anaesthesiologists (WFSA) Anesthesia Facility Assessment Tool (AFAT) previously identified 37 public Guatemalan hospitals that provide surgical care. Nine additional public non-surgical hospitals were also identified. Geospatial analysis was performed to estimate walking and driving geographic access to all 46 hospitals. We calculated the potential increase in access that would accompany the expansion of surgical services at each of the nine non-surgical hospitals.
The percentage of the population with walking access to a surgical hospital within 30 min, 1 h, and 2 h are 5·1%, 12·9%, and 27·3%, respectively. The percentage of people within 30 min, 1 h, and 2 h driving times are 27·3%, 41·1%, and 53·1%, respectively. The median percentage of the population within each of Guatemala's 22 administrative departments with 2 h walking access was 19·0% [IQR 14·1-30·7] and 2 h driving access was 52·4% [IQR 30·5-62·8]. Expansion of surgical care at existing public Guatemalan hospitals in Guatemala would result in a minimal increase in overall geographic access compared to current availability.
While Guatemala provides universal health coverage, geographic access to surgical care remains inadequate. Geospatial mapping and survey data work synergistically to assess surgical system strength and identify gaps in geographic access to essential surgical care.
None.
前往能够进行急诊普通外科手术和剖宫产的医院的两小时和30分钟出行时间是及时获得手术治疗的基准。本研究旨在估计危地马拉能够及时获得手术治疗的人口数量，并确定扩大手术服务将增加可及性的现有医院。
世界麻醉医师协会联合会（WFSA）麻醉设施评估工具（AFAT）先前确定了37家提供手术治疗的危地马拉公立医院。还确定了另外9家非手术公立医院。进行了地理空间分析，以估计步行和驾车前往所有46家医院的地理可及性。我们计算了9家非手术医院中每家医院扩大手术服务后可及性的潜在增加量。
在30分钟、1小时和2小时内步行可到达手术医院的人口百分比分别为5.1%、12.9%和27.3%。在30分钟、1小时和2小时驾车时间内的人口百分比分别为27.3%、41.1%和53.1%。危地马拉22个行政区中，每家行政区在2小时步行可及范围内的人口中位数百分比为19.0%[四分位间距14.1 - 30.7]，在2小时驾车可及范围内的人口中位数百分比为52.4%[四分位间距30.5 - 62.8]。与目前的可及性相比，危地马拉现有公立医院扩大手术治疗将导致总体地理可及性的增加微乎其微。
虽然危地马拉提供全民医保，但手术治疗的地理可及性仍然不足。地理空间测绘和调查数据协同工作，以评估手术系统的实力，并确定基本手术治疗地理可及性方面的差距。
无。
Zotero 插件
