Devanbu Vinoth Gnana Chellaiyan, R Narendranath, A Sanjutha, Kumar Neeta
Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, IND.
Community Medicine, KMCH Institute of Health Sciences and Research, Coimbatore, IND.
Cureus. 2023 Sep 23;15(9):e45808. doi: 10.7759/cureus.45808. eCollection 2023 Sep.
Introduction Situational analysis of exciting infrastructure including mobile health services is crucial for comprehensive healthcare delivery. The concept of mDiagnostics has gained traction as it addresses the challenges of accessibility, affordability, and availability of healthcare services in remote regions. Purpose The study was to do a situational analysis of the availability of medical diagnostic facilities and identify the challenges and barriers faced in the implementation and utilisation of mDiagnostics. Material and methods The present study was a mixed mixed-method study conducted in rural and urban areas of Chennai, Tamil Nadu, India. A total of 1,489 households were included. Situational analysis of existing healthcare facilities and the availability of Ayushman Bharat Health Account (ABHA) numbers for study participants in both urban and rural areas was assessed. In-depth interviews on user perspective, affordability, awareness of existing health services, and perception of the utility of mobile lab services and focus group discussions with healthcare professionals, community members, and key stakeholders were carried out. Thematic analysis for qualitative data, proportion, and means were calculated for the quantitative component. Result Out of 1,489 households included, 711 were from rural areas, and 778 were from urban areas. The distance traveled from their residence to both the lab and health facility was less than 5 km in urban areas, while it is more than 5 km in rural areas. The mean expenditure in availing healthcare services is above five thousand rupees per annum in nearly half of the rural households (46%) and 60% of urban. The analyses of interviews explored the availability, acceptability, and affordability under seven thematic areas for situational analysis of healthcare facilities, and a focused group discussion was held to explore the community member's barrier to healthcare services. Conclusion The study reveals a comprehensive understanding of healthcare delivery access disparities between rural and urban areas in Tamil Nadu. The findings highlighted the potential benefits of mobile lab initiatives in improving healthcare access and early disease detection in underserved rural communities.
引言 对包括移动健康服务在内的现有基础设施进行情境分析，对于全面提供医疗保健至关重要。移动诊断（mDiagnostics）的概念越来越受到关注，因为它解决了偏远地区医疗服务可及性、可负担性和可用性方面的挑战。
目的 本研究旨在对医疗诊断设施的可用性进行情境分析，并确定在移动诊断的实施和使用中面临的挑战和障碍。
材料和方法 本研究是一项在印度泰米尔纳德邦金奈城乡地区开展的混合方法研究。共纳入1489户家庭。评估了城乡地区现有医疗设施的情境分析以及研究参与者的阿育吠陀·巴拉特健康账户（ABHA）号码的可用性。就用户视角、可负担性、对现有健康服务的认知以及对移动实验室服务效用的看法进行了深入访谈，并与医疗专业人员、社区成员和关键利益相关者进行了焦点小组讨论。对定性数据进行主题分析，对定量部分计算比例和均值。
结果 在纳入的1489户家庭中，711户来自农村地区，778户来自城市地区。城市地区居民从住所到实验室和医疗机构的距离均小于5公里，而农村地区则超过5公里。近一半（46%）的农村家庭和60%的城市家庭每年在获得医疗服务方面的平均支出超过5000卢比。访谈分析在七个主题领域探讨了医疗设施情境分析中的可用性、可接受性和可负担性，并举行了焦点小组讨论以探讨社区成员获得医疗服务的障碍。
结论 该研究揭示了对泰米尔纳德邦城乡地区医疗服务可及性差异的全面理解。研究结果突出了移动实验室举措在改善医疗服务可及性和在服务不足的农村社区进行早期疾病检测方面的潜在益处。
