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Patient Perspectives on Barriers to Surgical Care and the Impact of Mobile Surgery in Ecuador

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Abstract

Background

An estimated 5 billion people worldwide lack access to timely safe surgical care (Gawande in Lancet 386(9993):523–525, 2015). A mere 6% of all surgical procedures occur in the poorest countries where over a third of the world’s population lives (Meara et al. in Surgery 158(1):3–6, 2015). Mobile surgical units like the Cinterandes Foundation endeavor to bring surgical care directly to these communities who otherwise would lack access to safe surgery. This study examines the barriers patients encounter in seeking surgical care in rural communities of Ecuador and their impressions on how mobile surgery addresses such barriers.

Methods

Open interviews were conducted with Cinterandes’ patients who had undergone an operation in the mobile surgical unit between 06/25/2013 and 06/25/2014 (n = 101). Interviews were structured to explore two main domains: (1) examining barriers patients have in accessing surgery, (2) assessing patients’ opinion of how mobile surgery helped in overcoming such barriers.

Results

Patient inconvenience (70%), cost (21%), and lack of trust in local hospitals (24%) were the main cited barriers to surgical access. Increased patient convenience (53%), cheaper surgical care (34%), and trust in Cinterandes (47%) were the main cited benefits to mobile surgery.

Conclusion

Mobile surgery provided by Cinterandes effectively overcomes many barriers patients encounter when seeking surgical care in rural Ecuador: decreased patient wait times, limited number of referrals to multiple locations, and decreased cost. Partnering with local clinics within the communities and bringing care much closer to patients’ homes may provide a better patient friendly health care delivery system for rural Ecuador.

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Acknowledgements

Dr. Edgar Rodas, the founder of The Cinterandes Foundation, passed away on March 3, 2015. His vision and leadership are what have enabled Cinterandes to be one of the most successful mobile surgical units in the developing world. His efforts have benefited, and continue to benefit, the lives of thousands across all of Ecuador. Further acknowledgements and thanks are made to Anita Vicuña (Anesthesiologist), Fredy Peralta (operating room technician), Gonzalo Matute (driver and assistant), and Carolina Donoso (general coordinator) for their substantial aid and initiatives in acquiring archived and current data and documents.

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Authors and Affiliations

  1. University of Utah School of Medicine, 30 North 1900 East, Salt Lake City, UT, 84132, USA

    Matthew D. Price

  2. Cinterandes Foundation, Cuenca, Ecuador

    Matthew D. Price, Haadi T. Shalabi, Blasco Guzhñay & Edgar B. Rodas

  3. University of Nottingham, Nottingham, UK

    Haadi T. Shalabi

  4. Gold Coast University Hospital, Southport, QLD, Australia

    Haadi T. Shalabi & Saggah T. Shalabi

  5. Intermountain Health Care, Salt Lake City, UT, USA

    Raymond R. Price

  6. University of Utah Center for Global Surgery, Salt Lake City, UT, USA

    Raymond R. Price

  7. VCU Division of Acute Care Services, Richmond, VA, USA

    Edgar B. Rodas

Authors
  1. Matthew D. Price
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  2. Haadi T. Shalabi
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  3. Blasco Guzhñay
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  4. Saggah T. Shalabi
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  5. Raymond R. Price
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  6. Edgar B. Rodas
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Corresponding author

Correspondence to Matthew D. Price.

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All authors declare that they have no conflict of interest.

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Price, M.D., Shalabi, H.T., Guzhñay, B. et al. Patient Perspectives on Barriers to Surgical Care and the Impact of Mobile Surgery in Ecuador. World J Surg 41, 2417–2422 (2017). https://doi.org/10.1007/s00268-017-4056-x

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  • DOI: https://doi.org/10.1007/s00268-017-4056-x

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