Abstract
Background
The World Health Organization has identified the primary referral hospital as its priority site for improving surgical care in low- and middle-income countries. Little is known about the relative burden surgical patients place on health care facilities at this level. This research estimates the fraction of admissions due to surgical conditions at three hospitals in rural Mozambique.
Methods
Prospective data were collected on all inpatients at three primary referral hospitals in Mozambique during a 12-day period. We compared the number of surgical patients and their length of stay (LOS) to the patients admitted to the medicine, pediatric, and maternity wards. These findings were validated using retrospective data collected from one hospital from January to May 2012.
Results
Patients with surgical conditions (i.e., patients admitted to the surgical or maternity ward) accounted for 57.5 % of admissions and 48.0 % of patient-days. The majority of patients were admitted to the maternity ward (32.3 %). The other admissions were evenly distributed to the pediatric (22.5 %), medical (20.0 %), and surgical (25.2 %) wards. Compared to patients from the three other wards, surgical patients had longer average LOS (8.7 vs. 1.9–7.7 days) and a higher number of total patient-days (891 vs. 252–703 days). The most prevalent procedures were cesarean section (33.3 %) and laceration repair/wound care (11.8 %).
Conclusions
Surgical conditions are the most common reason for admissions at three primary referral hospitals in rural Mozambique. These data suggest that surgical care is a major component of health care delivered at primary referral hospitals in Mozambique and likely other sub-Saharan African countries.
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Acknowledgments
The research was supported by Grant No. R24TW008910 from the Fogarty International Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Fogarty International Center or the National Institutes of Health. The NIH Common Fund supports the first award.
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Anderson, J.E., Erickson, A., Funzamo, C. et al. Surgical Conditions Account for the Majority of Admissions to Three Primary Referral Hospitals in Rural Mozambique. World J Surg 38, 823–829 (2014). https://doi.org/10.1007/s00268-013-2366-1
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DOI: https://doi.org/10.1007/s00268-013-2366-1