Paediatric and obstetric outcomes at a faith-based hospital during the 100-day public sector physician strike in Kenya
Paediatric and obstetric outcomes at a faith-based hospital during the 100-day public sector physician strike in Kenya
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DOI：
10.1136/bmjgh-2017-000665
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发表时间：
2018-03-01
影响因子：
8.1
通讯作者：
Hansen, Erik N.
中科院分区：
文献类型：
--
作者：
Adam, Mary Beth;Muma, Sarah;Hansen, Erik N.
发表的全国医生罢工评论显示，病人死亡率下降。从2016年12月5日至2017年3月14日，肯尼亚公共部门的医生罢工，只留下私人（非营利和营利）医院能够提供医生护理。我们报告我们在AIC Kijabe医院的经验，这是一家非营利性的，基于信仰的肯尼亚医院，在100天的罢工完成之前，期间和之后，通过检查罢工之前，期间和之后的病人入院和死亡。病人的数量增加，超出了医院应对需求的能力。在此期间，新生儿住院人数大幅增加，并为满足这一需求增设了一个病房。所有服务的需求都有所增加，但人员配置和空间限制了应对需求增加的能力。在罢工期间，儿科医疗、新生儿、儿科外科和产科单位的死亡人数增加，死亡的OR（95% CI）分别为3.9（95% CI 2.3至6.4）、4.1（95% CI 2.4至7.1）、7.9（95% CI 3.2至20）和3.2（95% CI 0.39至27）。在肯尼亚全国医生罢工期间，AIC Kijabe医院的儿科和产科服务死亡率上升与公共部门的医疗服务瘫痪有关。
Published reviews of national physician strikes have shown a reduction in patient mortality. From 5 December 2016 until 14 March 2017, Kenyan physicians in the public sector went on strike leaving only private (not-for-profit and for-profit) hospitals able to offer physician care. We report on our experience at AIC-Kijabe Hospital, a not-forprofit, faith-based Kenyan hospital, before, during and after the 100-day strike was completed by examining patient admissions and deaths in the time periods before, during and after the strike. The volume of patients increased and exceeded the hospital's ability to respond to needs. There were substantial increases in sick newborn admissions during this time frame and an additional ward was opened to respond to this need. Increased need occurred across all services but staffing and space limited ability to respond to increased demand. There were increases in deaths during the strike period across the paediatric medical, newborn, paediatric surgical and obstetric units with an OR (95% CI) of death of 3.9 (95% CI 2.3 to 6.4), 4.1 (95% CI 2.4 to 7.1), 7.9 (95% CI 3.2 to 20) and 3.2 (95% CI 0.39 to 27), respectively. Increased mortality across paediatric and obstetrical services at AIC-Kijabe Hospital correlated with the crippling of healthcare delivery in the public sector during the national physicians' strike in Kenya.