Admissions and surgery as indicators of hospital functions in Sierra Leone during the west-African Ebola outbreak
Admissions and surgery as indicators of hospital functions in Sierra Leone during the west-African Ebola outbreak
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DOI：
10.1186/s12913-018-3666-9
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发表时间：
2018-11-09
影响因子：
2.8
通讯作者：
von Schreeb, Johan
中科院分区：
文献类型：
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作者：
Bolkan, Hakon A.;van Duinen, Alex;von Schreeb, Johan
背景为了评估埃博拉病毒病（EVD）对塞拉利昂医院功能的影响，本研究的目的是评估在EVD爆发的第一年期间手术和非埃博拉入院的规定的变化。在2014年1月至2015年5月期间进行剖腹产和腹股沟疝修补术，共72周。在2014年9月至2015年5月的疫情高峰期间，从每两周一次的访视中随时可用的医院记录中收集每周累积数据。使用Mann-Whitney U检验比较EVD爆发第一年与爆发前20周的每周中位入院人数，以及EVD爆发第一年与2012年相同周的每周中位手术量。手稿是准备根据选通检查表的横截面studies.ResultsOf确定的42家医院，40个可用的数据为94%（2719/2880）的周。与疫情爆发前20周（入院）和2012年（手术量）相比，每周非埃博拉入院中位数减少了51%，每周手术中位数减少了41%。与私立非营利性医院相比，公立医院的非埃博拉入院率（45%对60%）和手术率（31%对53%）下降幅度较小。政府医院实现了45%的EVD爆发期间剖宫产分娩量的增加，从而吸收了43%的减少观察到的私人非营利性hospital.ConclusionsBoth非埃博拉入院和手术严重减少EVD爆发期间。除了应对埃博拉病毒病爆发外，政府医院还能够维持某些核心卫生系统功能。手术量是一个有前途的指标，医院的功能，应进一步探讨。
BackgroundIn an attempt to assess the effects of the Ebola viral disease (EVD) on hospital functions in Sierra Leone, the aim of this study was to evaluate changes in provisions of surgery and non-Ebola admissions during the first year of the EVD outbreak.MethodsAll hospitals in Sierra Leone known to perform inpatient surgery were assessed for non-Ebola admissions, volume of surgery, caesarean deliveries and inguinal hernia repairs between January 2014 and May 2015, which was a total of 72weeks. Accumulated weekly data were gathered from readily available hospital records at bi-weekly visits during the peak of the outbreak from September 2014 to May 2015. The Mann-Whitney U test was used to compare weekly median admissions during the first year of the EVD outbreak, with the 20weeks before the outbreak, and weekly median volume of surgeries performed during the first year of the EVD outbreak with identical weeks of 2012. The manuscript is prepared according to the STROBE checklist for cross-sectional studies.ResultsOf the 42 hospitals identified, 40 had available data for 94% (2719/2880) of the weeks. There was a 51% decrease in weekly median non-Ebola admissions and 41% fewer weekly median surgeries performed compared with the 20weeks before the outbreak (admission) and 2012 (volume of surgery). Governmental hospitals experienced a smaller reduction in non-Ebola admissions (45% versus 60%) and surgeries (31% versus 53%) compared to private non-profit hospitals. Governmental hospitals realized an increased volume of cesarean deliveries by 45% during the EVD outbreak, thereby absorbing the 43% reduction observed in the private non-profit hospitals.ConclusionsBoth non-Ebola admissions and surgeries were severely reduced during the EVD outbreak. In addition to responding to the EVD outbreak, governmental hospitals were able to maintain certain core health systems functions. Volume of surgery is a promising indicator of hospital functions that should be further explored.