Decentralising paediatric hearing services through district healthcare screening in Western Cape province, South Africa
| Autor: | Alex J. Scott, Silva Kuschke, Daniel C. d.W. Swanepoel, Talita le Roux |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Hearing loss Otoacoustic Emissions Spontaneous otoacoustic emissions Primary care childhood hearing loss Pediatrics Health Services Accessibility South Africa Audiometry Hearing hearing healthcare Health care medicine Humans Mass Screening low- and middle-income countries Hearing Loss Hearing Disorders business.industry Attendance rate Hearing Tests Public Health Environmental and Occupational Health Attendance decentralisation Audiology General Medicine Child Preschool Family medicine Western cape Medicine Female Electronic database Public aspects of medicine RA1-1270 medicine.symptom Level of care Family Practice business Delivery of Health Care |
| Zdroj: | African Journal of Primary Health Care & Family Medicine, Vol 13, Iss 1, Pp e1-e7 (2021) |
| ISSN: | 2071-2936 2071-2928 |
| DOI: | 10.4102/phcfm.v13i1.2903 |
| Popis: | Background: Childhood hearing loss is a global epidemic most prevalent in low- and middle-income countries where hearing healthcare services are often inaccessible. Referrals for primary care services to central hospitals add to growing lists and delays the time-sensitive treatment of childhood hearing loss. Aim: To compare a centralised tertiary model of hearing healthcare with a decentralised model through district hearing screening for children in the Western Cape province, South Africa. Setting: A central paediatric tertiary hospital in Cape Town and a district hospital in the South Peninsula region. Methods: A pragmatic quasi-experimental study design was used with a 7-month control period at a tertiary hospital (June 2019 to December 2019). Decentralising was measured by attendance rates, travelling distance, number of referrals to the tertiary hospital and hearing outcomes. There were 315 children in the tertiary group and 158 in the district group. Data were collected from patient records and an electronic database at the tertiary hospital. Results: Attendance rate at the district hospital was significantly higher ( p < 0.001). Travel distance to the district hospital was significantly shorter ( p < 0.001). Number of referrals to the tertiary hospital decreased significantly during the intervention period ( p < 0.001). Most children in both the tertiary and district groups (78.7% and 80.4%, respectively) passed initial hearing screening bilaterally. Conclusion: Hearing screening should be conducted at the appropriate level of care to increase access, reduce patient travelling distances and associated costs and reduce the burden on tertiary-level hospitals. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|