印度的急性腹部疾病死亡率和外科治疗的地理位置:以全国代表性人口为基础的空间分析
Joshua S Ng-Kamstra1, Anna J Dare1, Jayadeep Patra1
1Centre for Global Health Research, St Michael's Hospital and University of Toronto, Toronto, ON, Canada.
印度的急性腹部疾病死亡与外科治疗的地理位置有关. 改善医院资源可以避免每年超过5万例死亡.
科学领域:
- 全球健康
- 提供外科护理
- 公共卫生政策
背景情况:
- 在没有及时手术的情况下, 急性腹部疾病的死亡率很高.
- 低收入和中等收入国家手术死亡率和手术获取率的数据有限.
- 关于印度急性腹部炎死亡的研究很少.
研究的目的:
- 分析印度DAA的空间和社会经济分布.
- 评估与DAA相关的手术设施的准入.
- 为减少手术死亡率制定公共卫生战略.
主要方法:
- 通过对110万印度家庭的全国代表性死亡率调查.
- 将死亡数据与国家设施数据联系起来进行地理分析.
- 使用空间聚类 (Getis-Ord Gi*) 来确定高死亡率的地区.
- 在高死亡率与低死亡率的群体中比较获得资源充足的外科护理.
主要成果:
- 在印度 (2010年) 全国估计有72,000例DAA,其中71%发生在家中,87%发生在农村地区.
- 主要原因是胃潰瘍 (79%).
- 死亡率较高的群体与资源充足的医院相距更远 (OR为> 50公里,OR为> 100公里).
结论:
- 增加公共医院的资源对于减少印度的DAA至关重要.
- 在50公里范围内改善医院设施, 可以避免每年超过5万例DAA死亡.
- 专注于公共服务对于穷人来说至关重要,
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