Surgical System Efficiency and Operative Productivity in Public and Private Health Facilities in Ethiopia: A Cross-Sectional Evaluation.

Autor:	Sibhatu MK; Jhpiego, Addis Ababa, Ethiopia. manuelcircle@gmail.com.; Addis Ababa University, Addis Ababa, Ethiopia., Getachew EM; Armauer Hansen Research Institute, Addis Ababa, Ethiopia., Bete DY; Armauer Hansen Research Institute, Addis Ababa, Ethiopia., Gebreegziabher SB; Ministry of Health of Ethiopia, Addis Ababa, Ethiopia., Kumsa TH; Ministry of Health of Ethiopia, Addis Ababa, Ethiopia., Shagre MB; Ministry of Health of Ethiopia, Addis Ababa, Ethiopia., Merga KH; Ministry of Health of Ethiopia, Addis Ababa, Ethiopia., Taye DB; Jhpiego, Addis Ababa, Ethiopia., Bashir HM; Jhpiego, Addis Ababa, Ethiopia., Yicheneku MT; Ministry of Health of Ethiopia, Addis Ababa, Ethiopia., Zewude WC; Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia., Ashuro AA; Ministry of Health of Ethiopia, Addis Ababa, Ethiopia., Ashengo TA; Jhpiego, Addis Ababa, Ethiopia., Meshesha BR; Jhpiego, Addis Ababa, Ethiopia.; Saint Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Jazyk:	angličtina
Zdroj:	Global health, science and practice [Glob Health Sci Pract] 2024 Feb 09. Date of Electronic Publication: 2024 Feb 09.
DOI:	10.9745/GHSP-D-22-00277
Abstrakt:	Background: Global and local health organizations track surgical system efficiency to improve surgical system performance using various efficiency metrics, such as operating room (OR) output, surgical incision start time (SIST), turnover time (TOT), cancellation rate among elective surgeries, and in-hospital surgery wait time. We evaluated the surgical system efficiency and factors affecting the efficiency in health facilities across Ethiopia. Methods: A cross-sectional study design with retrospective record review was used to evaluate the surgical system efficiency in 163 public and private health facilities in Ethiopia from December 2020 to June 2021. Experienced, trained surgical clinicians abstracted efficiency data from service registers and patient charts using a pretested tool. A bivariable and multivariable regression analysis was conducted. Results: In the study facilities, 84.11% of the operating tables were functional, and 68,596 major surgeries were performed. The aggregate OR output in both public and private health facilities was 2 surgeries per day per OR table. Operating productivity was shown to be affected by first-case SIST ( P =.004). However, of the total 881 surgery incision times audited, 19.86% of the first-of-the-day elective surgeries started after 10:01 am. The SIST was strongly associated with an in-hospital wait time for surgery ( P =.016). The elective surgery cancellation rate was 5.2%, and aggregate mean TOT was 50.25 minutes. The mean in-hospital surgery wait time was 45.40 hours, longer than the national cutoff for wait time. In a bivariable analysis, the independent variables that demonstrated association operating room productivity were then inputted into a multivariable regression analysis model. However, none of the predictor/independent variables showed significance in the multivariable regression analysis model. Conclusion: The volume of surgery and overall OR productivity in Ethiopia is low. This calls for concerted action to optimize OR efficiency and improve access to timely and safe surgical care in Ethiopia and other LMICs. (© Sibhatu et al.)
Databáze:	MEDLINE
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