Inpatient healthcare provider bypassing by women and their children in urban Bo, Sierra Leone.
Inpatient healthcare provider bypassing by women and their children in urban Bo, Sierra Leone.
复制标题
DOI：
10.11604/pamj.2016.23.146.8706
复制
发表时间：
2016-01-01
期刊：
影响因子：
--
通讯作者：
Jacobsen, Kathryn H
中科院分区：
文献类型：
--
作者：
Fleming, Lila C;Ansumana, Rashid;Jacobsen, Kathryn H
简介：绕过指的是一个人决定到离自己家最近的医疗机构寻求护理。方法：这项研究使用2010-2011年间接受采访的1,980名有15岁及以下孩子的妇女的数据，调查了塞拉利昂博市的住院护理机构绕过。利用地理信息系统(GIS)识别住宅建筑和医院的位置，并测量参与调查的家庭到最近和首选的住院护理设施的道路距离。结果：9个住院护理设施为博市居民服务，但超过70%的参与妇女报告说，位于市中心的市内主要公立医院(博政府医院)是她们首选的住院护理机构。参与者居住在距他们最近的住院设施0.9公里(四分位数范围(IQR)：0.6，1.8)的中位距离内，但他们将步行2.4公里(IQR：1.0，3.3)到达他们首选的提供者。大约87%的女性会绕过最近的住院护理机构，到首选的提供者那里获得护理。不同人口和社会经济群体的避孕率相似，但居住在离市中心较远的女性的避孕率更高。结论：尽管薄拥有多元化的医疗市场，但获得负担得起的高级护理选择的机会有限。大多数薄妇女会选择绕过离家更近的设施，寻求薄政府医院提供的低成本和全面的护理。
INTRODUCTION: Bypassing refers to a person's decision to seek care at a healthcare facility that is not the nearest one of its type to the person's home.METHODS: This study examined inpatient care facility bypassing in urban Bo, Sierra Leone using data from 1,980 women with children 15 years of age and younger who were interviewed in 2010-2011. The locations of residential structures and hospitals were identified using a geographic information system (GIS), and the road distances from participating households to the nearest and preferred inpatient care facilities were measured.RESULTS: Nine inpatient care facilities serve Bo residents, but more than 70% of the participating women reported that the city's main public hospital (Bo Government Hospital), located in the city center, was their preferred inpatient care provider. Participants resided within a median distance of 0.9 km (Interquartile range (IQR): 0.6, 1.8) from their closest inpatient facility, but they would travel a median distance of 2.4 km (IQR: 1.0, 3.3) to reach their preferred providers. About 87% of the women would bypass their nearest inpatient care facility to access care at a preferred provider. Bypassing rates were similar for various demographic and socioeconomic groups, but higher for women living farther from the city center.CONCLUSION: Although Bo has a diverse healthcare marketplace, access to affordable advanced care options is limited. Most women in Bo would choose to bypass facilities nearer to their homes to seek the low-cost and comprehensive care offered by Bo Government Hospital.