The impact of the COVID-19 pandemic on hospital utilisation in Sierra Leone.
The impact of the COVID-19 pandemic on hospital utilisation in Sierra Leone.
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DOI：
10.1136/bmjgh-2021-005988
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发表时间：
2021-10
影响因子：
8.1
通讯作者：
Leather AJM
中科院分区：
文献类型：
--
作者：
Sevalie S;Youkee D;van Duinen AJ;Bailey E;Bangura T;Mangipudi S;Mansaray E;Odland ML;Parmar D;Samura S;van Delft D;Wurie H;Davies JI;Bolkan HA;Leather AJM
新冠肺炎大流行对许多国家的卫生系统造成了不利影响，但对撒哈拉以南非洲卫生系统的影响知之甚少。这项研究考察了新冠肺炎对撒哈拉以南国家塞拉利昂医院利用率的影响。混合方法研究使用纵向全国医院数据(入院、手术、分娩和转诊)和对医护人员和患者的定性访谈。比较了2020年各季度的医院数据(Q)，第二季度的第一天代表塞拉利昂大流行的开始。入院人数按性别、服务(外科、内科、妇产科和儿科)和医院类型(政府或私立非营利组织)报告。将2020年的转介与2019年的转介进行了比较，以评估是否有任何变化是季节性的结果。比较采用学生t检验。定性数据采用专题分析方法进行分析。从第一季度到第二季度，每周平均住院人数下降了14.7%(p=0.005)。男性的降幅为18.8%，女性的降幅为12.5%。降幅最大的是外科入院，减少了49.8%(p<；0.001)和内科入院，减少了28.7%(p=0.002)。儿科和产科入院人数没有显著变化。手术总数减少了13.9%(p<；0.001)，而剖腹产和基于设施的分娩显著增加：分别为12.7%(p=0.014)和7.5%(p=0.03)。第三季度，总招生人数仍然比第一季度下降了13.2%(p<；0.001)。与2019年相比，2020年第二季度和第三季度的每周平均转诊次数较低，这表明调查结果不太可能是季节性的。定性分析确定了供给侧因素，即基本服务的优先顺序、新冠肺炎服务的引入和暂停选择性护理，以及需求侧因素、对医院感染的恐惧和经济困难。这项研究表明，在新冠肺炎期间，医院利用率有所下降，这一下降幅度低于其他国家在新冠肺炎期间的报告，也低于埃博拉疫情期间的报告。
The COVID-19 pandemic has adversely affected health systems in many countries, but little is known about effects on health systems in sub-Saharan Africa. This study examines the effects of COVID-19 on hospital utilisation in a sub-Saharan country, Sierra Leone. Mixed-methods study using longitudinal nationwide hospital data (admissions, operations, deliveries and referrals) and qualitative interviews with healthcare workers and patients. Hospital data were compared across quarters (Q) in 2020, with day 1 of Q2 representing the start of the pandemic in Sierra Leone. Admissions are reported in total and disaggregated by sex, service (surgical, medical, maternity and paediatric) and hospital type (government or private non-profit). Referrals in 2020 were compared with 2019 to assess whether any changes were the result of seasonality. Comparisons were performed using Student’s t-test. Qualitative data were analysed using thematic analysis. From Q1 to Q2, weekly mean hospital admissions decreased by 14.7% (p=0.005). Larger decreases were seen in male 18.8% than female 12.5% admissions. The largest decreases were in surgical admissions, a 49.8% decrease (p<0.001) and medical admissions, a 28.7% decrease (p=0.002). Paediatric and maternity admissions did not significantly change. Total operations decreased by 13.9% (p<0.001), while caesarean sections and facility-based deliveries showed significant increases: 12.7% (p=0.014) and 7.5% (p=0.03), respectively. In Q3, total admissions remained 13.2% lower (p<0.001) than Q1. Mean weekly referrals were lower in Q2 and Q3 of 2020 compared with 2019, suggesting findings were unlikely to be seasonal. Qualitative analysis identified both supply-side factors, prioritisation of essential services, introduction of COVID-19 services and pausing elective care, and demand-side factors, fear of nosocomial infection and financial hardship. The study demonstrated a decrease in hospital utilisation during COVID-19, the decrease is less than reported in other countries during COVID-19 and less than reported during the Ebola epidemic.
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塞拉利昂的埃博拉反应：对儿童的影响。
DOI：
10.1016/j.jinf.2016.04.016
发表时间：
2016-07-05
期刊：
The Journal of infection
影响因子：
--
作者：
Fitzgerald F;Awonuga W;Shah T;Youkee D
通讯作者：
Youkee D
影响因子：
2.2
作者：
Caviglia M;Buson R;Pini S;Jambai A;Vandy MJ;Venturini F;Rosi P;Barone-Adesi F;Della Corte F;Ragazzoni L;Putoto G
通讯作者：
Putoto G
影响因子：
5.2
作者：
Olu, Olushayo Oluseun;Lamunu, Margaret;Dafae, Foday Mohamed
通讯作者：
Dafae, Foday Mohamed
DOI：
10.11604/pamj.supp.2020.35.143.25367
发表时间：
2020
期刊：
The Pan African medical journal
影响因子：
--
作者：
Murewanhema G;Makurumidze R
通讯作者：
Makurumidze R
影响因子：
2.8
作者：
Bolkan, Hakon A.;van Duinen, Alex;von Schreeb, Johan
通讯作者：
von Schreeb, Johan