Abstract：
BACKGROUND: Access to emergency and essential surgical care is still unmet and accessibility is disproportionately inequitable in Ethiopia and other low-and middle-income countries. The aim of this study was to assess surgical care access in terms of capability, capacity, and timeliness of care in different levels of health care in Ethiopia.
METHODS: A cross-sectional study with retrospective data review was conducted in 172 health facilities from December 30, 2020 to June 10, 2021. Descriptive statistics such as median with interquartile range and proportion were computed using STATA Version 15 statistical software.
RESULTS: Within a 90-day interval of the study period, 69,717 major and minor surgeries, and 33,052 bellwether procedures were performed, and major surgeries accounted for 58% of the surgeries. About 1.6%, 23.56%, 25.34%, and 32.2% of both major and minor, and 3.1%, 12.8%, 27.6%, and 45.3% of bellwether procedures were performed in health center OR blocks, primary, general, and specialized hospitals, respectively. Private hospitals performed 17.33% of major and minor and 11.2% of bellwether procedures for the period. The average pre-admission waiting time for surgical patients in primary, general, and specialized hospitals was 9.68, 37.6, and 35.9 days, respectively, whereas, in private hospitals, the average pre-admission waiting time was 1.42 days. On average, surgical patients traveled 5 Hrs, 11 Hrs, 28.4 Hrs, and 21.3 Hrs to access surgical services in primary, general, specialized, and private hospitals, respectively. The surgical workforce to the population served ratio was 7.5, 1.15, and 1.31/100.000 population in primary, specialized and general hospitals, respectively.
CONCLUSIONS: Most surgical procedures were performed in specialized hospitals, indicating that there is a burden in these health facilities. The pre-admission waiting time for surgical patients was long in higher-level public hospitals. Surgical patients traveled a long distance to access surgical service in higher level hospitals. The ratio of surgical workforce per 100,000 population served was low in all levels of public health facilities in general, and in higher level hospitals in particular. Efforts should therefore be made to strengthen all levels of the health system and improve surgical care access in terms of capacity, capability, and timeliness in the country.
METHODS: A cross-sectional study with retrospective data review was conducted in 172 health facilities from December 30, 2020 to June 10, 2021. Descriptive statistics such as median with interquartile range and proportion were computed using STATA Version 15 statistical software.
RESULTS: Within a 90-day interval of the study period, 69,717 major and minor surgeries, and 33,052 bellwether procedures were performed, and major surgeries accounted for 58% of the surgeries. About 1.6%, 23.56%, 25.34%, and 32.2% of both major and minor, and 3.1%, 12.8%, 27.6%, and 45.3% of bellwether procedures were performed in health center OR blocks, primary, general, and specialized hospitals, respectively. Private hospitals performed 17.33% of major and minor and 11.2% of bellwether procedures for the period. The average pre-admission waiting time for surgical patients in primary, general, and specialized hospitals was 9.68, 37.6, and 35.9 days, respectively, whereas, in private hospitals, the average pre-admission waiting time was 1.42 days. On average, surgical patients traveled 5 Hrs, 11 Hrs, 28.4 Hrs, and 21.3 Hrs to access surgical services in primary, general, specialized, and private hospitals, respectively. The surgical workforce to the population served ratio was 7.5, 1.15, and 1.31/100.000 population in primary, specialized and general hospitals, respectively.
CONCLUSIONS: Most surgical procedures were performed in specialized hospitals, indicating that there is a burden in these health facilities. The pre-admission waiting time for surgical patients was long in higher-level public hospitals. Surgical patients traveled a long distance to access surgical service in higher level hospitals. The ratio of surgical workforce per 100,000 population served was low in all levels of public health facilities in general, and in higher level hospitals in particular. Efforts should therefore be made to strengthen all levels of the health system and improve surgical care access in terms of capacity, capability, and timeliness in the country.
摘要：
背景：在埃塞俄比亚和其他低收入和中等收入国家，获得紧急和基本外科护理的机会仍然没有得到满足，而且获得的机会不成比例地不公平。这项研究的目的是评估手术护理的能力，容量,以及埃塞俄比亚不同级别医疗保健中的护理及时性。
方法：从2020年12月30日至2021年6月10日，在172个医疗机构进行了一项具有回顾性数据回顾的横断面研究。使用STATA第15版统计软件计算描述性统计，例如具有四分位数范围和比例的中位数。
结果：在90天的研究间隔内，69,717次重大和次要手术，并执行了33,052个领头羊程序，大型手术占手术总数的58%。约1.6%,23.56%,25.34%,和32.2%的主要和次要，和3.1%，12.8%,27.6%,45.3%的领头羊手术是在健康中心或街区进行的，小学,一般,和专科医院，分别。在此期间，私立医院执行了17.33％的主要和次要程序，以及11.2％的领头羊程序。原发性手术患者的平均入院前等待时间，一般,专科医院分别为9.68、37.6和35.9天，分别,然而,在私立医院，平均入院前等待时间为1.42天.平均而言,手术病人走了5小时，11小时,28.4小时，和21.3小时获得初级手术服务，一般,专业,私人医院,分别。在小学，外科劳动力与所服务人口的比率分别为7.5、1.15和1.31/100.000。专科医院和综合医院，分别。
结论：大多数外科手术在专科医院进行，这表明这些卫生设施有负担。在较高级别的公立医院，手术患者的入院前等待时间较长。手术患者走了很长一段路才能在高级医院获得手术服务。在所有级别的公共卫生设施中，每10万人所服务的外科劳动力比例总体上较低，特别是在高级医院。因此，应努力加强各级卫生系统，并在能力方面改善手术护理，能力,和国家的及时性。
方法：从2020年12月30日至2021年6月10日，在172个医疗机构进行了一项具有回顾性数据回顾的横断面研究。使用STATA第15版统计软件计算描述性统计，例如具有四分位数范围和比例的中位数。
结果：在90天的研究间隔内，69,717次重大和次要手术，并执行了33,052个领头羊程序，大型手术占手术总数的58%。约1.6%,23.56%,25.34%,和32.2%的主要和次要，和3.1%，12.8%,27.6%,45.3%的领头羊手术是在健康中心或街区进行的，小学,一般,和专科医院，分别。在此期间，私立医院执行了17.33％的主要和次要程序，以及11.2％的领头羊程序。原发性手术患者的平均入院前等待时间，一般,专科医院分别为9.68、37.6和35.9天，分别,然而,在私立医院，平均入院前等待时间为1.42天.平均而言,手术病人走了5小时，11小时,28.4小时，和21.3小时获得初级手术服务，一般,专业,私人医院,分别。在小学，外科劳动力与所服务人口的比率分别为7.5、1.15和1.31/100.000。专科医院和综合医院，分别。
结论：大多数外科手术在专科医院进行，这表明这些卫生设施有负担。在较高级别的公立医院，手术患者的入院前等待时间较长。手术患者走了很长一段路才能在高级医院获得手术服务。在所有级别的公共卫生设施中，每10万人所服务的外科劳动力比例总体上较低，特别是在高级医院。因此，应努力加强各级卫生系统，并在能力方面改善手术护理，能力,和国家的及时性。
