PDF(Pubmed)
Abstract：
Timely access to safe and affordable surgery is essential for universal health coverage. To date, there are no studies evaluating 2-hour access to Bellwether procedures (caesarean section, laparotomy, open fracture management) in the Philippines. The objectives of this study were to measure the proportion of the population able to reach a Bellwether hospital within 2 hours in the Philippines and to identify areas in the country with the most surgically underserved populations.
All public hospitals with Bellwether capacities were identified from the Philippines Ministry of Health website. The service area tool in ArcGIS Pro was used to determine the population within a 2-hour drive time of a Bellwether facility. Finally, suitability modelling was conducted to identify potential future sites for a surgical facility that targets the most underserved regions in the Philippines.
428 Bellwether capable hospitals were identified. 85.1% of the population lived within 2 hours of one of these facilities. However, 6 regions had less than 80% of its population living within 2 hours of a Bellwether capable facility: Bicol, Eastern Visayas, Zamboanga, Autonomous region of Muslim Mindanao, Caraga and Mimaropa. Suitability analysis identified four regions-Caraga, Mimaropa, Calabarzon and Zamboanga-as ideal locations to build a new hospital with surgical capacity to improve access rates.
85.1% of the population of the Philippines are able to reach Bellwether capable hospitals within 2 hours, with regional disparities in terms of access rates. However, other factors such as weather, traffic conditions, financial access, availability of 24-hour surgical services and access to motorised vehicles should also be taken into consideration, as they also affect actual access rates.
All public hospitals with Bellwether capacities were identified from the Philippines Ministry of Health website. The service area tool in ArcGIS Pro was used to determine the population within a 2-hour drive time of a Bellwether facility. Finally, suitability modelling was conducted to identify potential future sites for a surgical facility that targets the most underserved regions in the Philippines.
428 Bellwether capable hospitals were identified. 85.1% of the population lived within 2 hours of one of these facilities. However, 6 regions had less than 80% of its population living within 2 hours of a Bellwether capable facility: Bicol, Eastern Visayas, Zamboanga, Autonomous region of Muslim Mindanao, Caraga and Mimaropa. Suitability analysis identified four regions-Caraga, Mimaropa, Calabarzon and Zamboanga-as ideal locations to build a new hospital with surgical capacity to improve access rates.
85.1% of the population of the Philippines are able to reach Bellwether capable hospitals within 2 hours, with regional disparities in terms of access rates. However, other factors such as weather, traffic conditions, financial access, availability of 24-hour surgical services and access to motorised vehicles should also be taken into consideration, as they also affect actual access rates.
摘要：
目的：及时获得安全和负担得起的手术对于全民健康覆盖至关重要。迄今为止,没有研究评估2小时接受Bellwether手术(剖腹产，剖腹手术,菲律宾的开放性骨折管理)。这项研究的目的是测量菲律宾能够在2小时内到达领头羊医院的人口比例，并确定该国手术服务最不足的地区。
方法：所有具有领头羊能力的公立医院均来自菲律宾卫生部网站。ArcGISPro中的服务区域工具用于确定Bellwether设施2小时车程内的人口。最后,进行了适宜性建模，以确定针对菲律宾服务最薄弱地区的外科设施的潜在未来地点。
结果：确定了428家具有领头羊能力的医院。85.1％的人口在其中一个设施的2小时内居住。然而,6个地区的人口不到80％的人口生活在具有领头羊能力的设施的2小时内：Bicol，东米沙亚,三宝颜,棉兰老岛穆斯林自治区，Caraga和Mimaropa.适宜性分析确定了四个区域-卡拉加，Mimaropa,卡拉巴松和三宝颜是建立具有手术能力的新医院的理想地点，可以提高接诊率。
结论：菲律宾85.1％的人口能够在2小时内到达具有领头羊能力的医院，在接入率方面存在地区差异。然而,其他因素，如天气，交通状况,金融准入，还应考虑24小时手术服务的可用性和使用机动车辆的机会，因为它们也会影响实际的访问率。
方法：所有具有领头羊能力的公立医院均来自菲律宾卫生部网站。ArcGISPro中的服务区域工具用于确定Bellwether设施2小时车程内的人口。最后,进行了适宜性建模，以确定针对菲律宾服务最薄弱地区的外科设施的潜在未来地点。
结果：确定了428家具有领头羊能力的医院。85.1％的人口在其中一个设施的2小时内居住。然而,6个地区的人口不到80％的人口生活在具有领头羊能力的设施的2小时内：Bicol，东米沙亚,三宝颜,棉兰老岛穆斯林自治区，Caraga和Mimaropa.适宜性分析确定了四个区域-卡拉加，Mimaropa,卡拉巴松和三宝颜是建立具有手术能力的新医院的理想地点，可以提高接诊率。
结论：菲律宾85.1％的人口能够在2小时内到达具有领头羊能力的医院，在接入率方面存在地区差异。然而,其他因素，如天气，交通状况,金融准入，还应考虑24小时手术服务的可用性和使用机动车辆的机会，因为它们也会影响实际的访问率。
