Department of Health Informatics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, University of Gondar, Gondar, Ethiopia.
BMC Health Serv Res. 2023 Jul 24;23(1):787. doi: 10.1186/s12913-023-09652-9.
Medical imaging plays a vital role in the accurate diagnosis, treatment and outcome prediction of many diseases and injuries. However, in many African countries, deserving populations do not have access to the proper medical imaging specialists' services. As a result, clinicians continue to struggle to provide medical imaging via consultation. However, little is known about conventional referral consultation practices and their challenges. This study, therefore, aimed to explore the practice and challenges of medical imaging service consultation among health professionals and patients in the context of the Ethiopian public healthcare delivery system.
Descriptive phenomenological study was employed to explore the practice of medical imaging service consultation among health professionals and patients in public hospitals of Amhara region from October 12, 2021 to December 29, 2021. Semi-structured interview guides were prepared separately for key-informant and in-depth interviews. A total of 21 participants (6 hospital managers, 4 medical directors, 4 department heads, 3 medical imaging coordinators and 4 patients) were selected using the maximum variation sampling technique. All interviews were audio-recorded, transcribed verbatim and subjected to inductive thematic analysis using Open Code 4.02 software.
Six major themes emerged following the thematic analysis: (1) medical image service delivery practices; (2) medical imaging consultation modalities; (3) benefits and drawbacks of the consultation modalities; (4) challenges; (5) challenge mitigation strategies; and (6) future recommendations. Image films, compact disks, and telegram apps were the consultation modalities used by the referring clinicians to send the medical images to radiologists. Frequent failure of imaging machines, delayed equipment maintenance, inadequate infrastructure, shortage of budget, lack of radiologists, and low-quality of printed image films were among the challenges influencing the medical imaging consultation service.
This research explored onsite and referral imaging consultation practices. However, there are many challenges encountered by the referring clinicians and the radiologists during the consultation process. These challenges could potentially affect clinicians' ability to provide timely diagnosis and treatment services which would ultimately affects patient health status and service delivery. Virtual consultation via teleradiology and enhancing clinicians' competence through long-term and short-term trainings are recommended to improve the referral consultation practice.
医学影像学在许多疾病和损伤的准确诊断、治疗和预后预测中发挥着至关重要的作用。然而，在许多非洲国家，有需要的人群无法获得适当的医学影像专家服务。因此，临床医生继续努力通过咨询提供医学影像。然而，人们对传统的转诊咨询实践及其挑战知之甚少。因此，本研究旨在探讨在埃塞俄比亚公共医疗服务提供系统中，卫生专业人员和患者对医学影像服务咨询的实践和挑战。
本研究采用描述性现象学研究方法，于 2021 年 10 月 12 日至 12 月 29 日期间，在阿姆哈拉地区的公立医院探索卫生专业人员和患者对医学影像服务咨询的实践。为关键信息提供者和深入访谈分别准备了半结构式访谈指南。采用最大变异抽样技术，共选择了 21 名参与者（6 名医院经理、4 名医疗主任、4 名部门负责人、3 名医学影像协调员和 4 名患者）。所有访谈均进行了录音，并逐字转录，然后使用 Open Code 4.02 软件进行归纳主题分析。
经过主题分析，出现了以下 6 个主要主题：（1）医学影像服务提供实践；（2）医学影像咨询模式；（3）咨询模式的优缺点；（4）挑战；（5）挑战缓解策略；（6）未来建议。放射科医生使用的咨询模式包括影像胶片、光盘和电报应用程序。成像机器频繁故障、设备维护延迟、基础设施不足、预算短缺、缺乏放射科医生以及打印影像胶片质量差等是影响医学影像咨询服务的挑战。
本研究探讨了现场和转诊成像咨询实践。然而，在咨询过程中，转诊临床医生和放射科医生都遇到了许多挑战。这些挑战可能会影响临床医生提供及时诊断和治疗服务的能力，最终影响患者的健康状况和服务提供。建议通过远程放射学进行虚拟咨询，并通过长期和短期培训提高临床医生的能力，以改善转诊咨询实践。
