Use of geospatial analysis for priority setting in surgical system investment in Guatemala.

Autor:	Buda AM; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA., Truche P; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA., Izquierdo E; Ministry of Public Health and Social Assistance, Guatemala City, Guatemala., Izquierdo S; Department of Anesthesiology, Herrera Llerandi Hospital, Guatemala City, Guatemala., Asturias S; Department of Surgery, Roosevelt Hospital, Guatemala City, Guatemala., Stankey M; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA., Park KB; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA., Peck G; Rutgers Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA.; Rutgers School of Public Health, Piscataway, NJ, USA., Juran S; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.; United Nations Population Fund, Regional Office for Latin America and the Caribbean, Panama City, Panama., Evans FM; Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.; Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Jazyk:	angličtina
Zdroj:	Lancet regional health. Americas [Lancet Reg Health Am] 2021 Dec 24; Vol. 7, pp. 100145. Date of Electronic Publication: 2021 Dec 24 (Print Publication: 2022).
DOI:	10.1016/j.lana.2021.100145
Abstrakt:	Background: Two-hour and 30 min travel times to a hospital capable of performing emergency general surgery and cesarean section are benchmarks for timely surgical access. This study aimed to estimate the population of Guatemala with timely access to surgical care and identify existing hospitals where the expansion of surgical services would increase access. Methods: The World Federation of Societies of Anaesthesiologists (WFSA) Anesthesia Facility Assessment Tool (AFAT) previously identified 37 public Guatemalan hospitals that provide surgical care. Nine additional public non-surgical hospitals were also identified. Geospatial analysis was performed to estimate walking and driving geographic access to all 46 hospitals. We calculated the potential increase in access that would accompany the expansion of surgical services at each of the nine non-surgical hospitals. Findings: The percentage of the population with walking access to a surgical hospital within 30 min, 1 h, and 2 h are 5·1%, 12·9%, and 27·3%, respectively. The percentage of people within 30 min, 1 h, and 2 h driving times are 27·3%, 41·1%, and 53·1%, respectively. The median percentage of the population within each of Guatemala's 22 administrative departments with 2 h walking access was 19·0% [IQR 14·1-30·7] and 2 h driving access was 52·4% [IQR 30·5-62·8]. Expansion of surgical care at existing public Guatemalan hospitals in Guatemala would result in a minimal increase in overall geographic access compared to current availability. Interpretation: While Guatemala provides universal health coverage, geographic access to surgical care remains inadequate. Geospatial mapping and survey data work synergistically to assess surgical system strength and identify gaps in geographic access to essential surgical care. Funding: None. Competing Interests: Faye Evans is the Chair of Education for the World Federation of Societies of Anaesthesiologists (WFSA) (© 2021 The Author(s).)
Databáze:	MEDLINE
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