Access to Burn Care in Low- and Middle-Income Countries: An Assessment of Timeliness, Surgical Capacity, and Affordability in a Regional Referral Hospital in Tanzania
| Autor: | Matthijs Botman, Thom C C Hendriks, Louise E M de Haas, Grayson S Mtui, Joost Binnerts, Emanuel Q Nuwass, Anuschka S Niemeijer, Mariëlle E H Jaspers, Hay A H Winters, Marianne K Nieuwenhuis, Paul P M van Zuijlen |
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| Přispěvatelé: | Plastic, Reconstructive and Hand Surgery, Amsterdam Movement Sciences - Restoration and Development, Amsterdam Movement Sciences, AMS - Tissue Function & Regeneration, Paediatric Surgery, Hanze University of Applied Sciences |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Burn injury
medicine.medical_specialty Contracture Referral brandwonden chirurgie Tanzania Health administration doorverwijzing en consultatie/statistieken & numerieke data referral and consultation/statistics & numerical data ontwikkelingslanden ziekenhuizen mensen Health care Medicine Humans burns surgery contractuur chirurgie Developing Countries Referral and Consultation Burn wound biology business.industry Surgical care Rehabilitation biology.organism_classification Hospitals contracture surgery Low and middle income countries kosten en kostenanalyse Emergency medicine Emergency Medicine Costs and Cost Analysis Surgery business Burns |
| Zdroj: | Journal of burn care & research : official publication of the American Burn Association, 43(3), 657-664. Lippincott Williams and Wilkins Journal of burn care & research, 43(3), 657-664. Lippincott Williams and Wilkins Journal of Burn Care and Research, 43(3), 657-664. Lippincott Williams and Wilkins Journal of burn care & research : official publication of the American Burn Association, 43(3), 657-664. Lippincott, Williams & Wilkins Botman, M, Hendriks, T C C, de Haas, L E M, Mtui, G S, Binnerts, J, Nuwass, E Q, Niemeijer, A S, Jaspers, M E H, Winters, H A H, Nieuwenhuis, M K & van Zuijlen, P P M 2022, ' Access to Burn Care in Low-and Middle-Income Countries : An Assessment of Timeliness, Surgical Capacity, and Affordability in a Regional Referral Hospital in Tanzania ', Journal of Burn Care and Research, vol. 43, no. 3, pp. 657-664 . https://doi.org/10.1093/jbcr/irab191 |
| ISSN: | 1559-047X |
| DOI: | 10.1093/jbcr/irab191 |
| Popis: | This study investigates patients’ access to surgical care for burns in a low- and middle-income setting by studying timeliness, surgical capacity, and affordability. A survey was conducted in a regional referral hospital in Manyara, Tanzania. In total, 67 patients were included. To obtain information on burn victims in need of surgical care, irrespective of time lapsed from the burn injury, both patients with burn wounds and patients with contractures were included. Information provided by patients and/or caregivers was supplemented with data from patient files and interviews with hospital administration and physicians. In the burn wound group, 50% reached a facility within 24 hours after the injury. Referrals from other health facilities to the regional referral hospital were made within 3 weeks for 74% in this group. Of contracture patients, 74% had sought healthcare after the acute burn injury. Of the same group, only 4% had been treated with skin grafts beforehand, and 70% never received surgical care or a referral. Together, both groups indicated that lack of trust, surgical capacity, and referral timeliness were important factors negatively affecting patient access to surgical care. Accounting for hospital fees indicated patients routinely exceeded the catastrophic expenditure threshold. It was determined that healthcare for burn victims is without financial risk protection. We recommend strengthening burn care and reconstructive surgical programs in similar settings, using a more comprehensive health systems approach to identify and address both medical and socioeconomic factors that determine patient mortality and disability. |
| Databáze: | OpenAIRE |
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