Document Detail

Barriers to accessing surgical care: a cross-sectional survey conducted at a tertiary care hospital in Karachi, Pakistan.
MedLine Citation:
PMID:  23765083     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The need for surgical care far exceeds available facilities, especially in low income and poor countries. Limited data are available to help us understand the extent and nature of barriers that limit access to surgical care, particularly in the Asian subcontinent. The aim of this study was to understand factors that influence access to surgical care in a low-income urban population.
METHODS: An observational cross-sectional study was conducted on 199 consecutive patients admitted for elective surgery from February to April 2010 to identify the presence and causes of delay in accessing surgical care.
RESULTS: The median duration of symptoms were 7 and 4 months in women and men, respectively. The odds of delay between the onset of symptoms and seeking initial health care (first interval) is twice as likely for women than for men [52.7 vs. 37.5 %, odds ratio (OR) 1.9]. Lack of knowledge regarding treatment options [OR 3.8; 95 % confidence interval (CI) 1.4-10.3] and about disease implications (OR 2.4; 95 % CI 1.2-4.8) were cited most often. A second interval of delay (time from when surgery was first advised to the surgery) was reported by 123 (61.8 %) patients. Financial constraints (29.6 %) and environment-related delays (10.6 %) were cited most often. More women than men thought there was a second delay interval (73 vs. 58 %). The odds of women having more co-morbid conditions were nearly 4.7 times that of men (95 % CI 1.5-15.1).
CONCLUSIONS: A complex interaction of factors limits access to surgical care in developing countries. Women appear to face greater hurdles to accessing health care. Understanding local factors is essential to make care accessible.
Lubna Samad; Fayez Jawed; Sana Zehra Sajun; Mohammad Hussham Arshad; Naila Baig-Ansari
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of surgery     Volume:  37     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-08-28     Completed Date:  2014-04-14     Revised Date:  2014-05-13    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2313-21     Citation Subset:  IM    
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MeSH Terms
Cross-Sectional Studies
Developing Countries*
Health Care Surveys
Health Knowledge, Attitudes, Practice
Health Services Accessibility* / economics,  statistics & numerical data
Odds Ratio
Patient Acceptance of Health Care
Sex Factors
Surgical Procedures, Elective* / economics,  statistics & numerical data
Tertiary Care Centers*
Urban Population
Comment In:
World J Surg. 2014 May;38(5):1243-4   [PMID:  24202398 ]
World J Surg. 2014 May;38(5):1245   [PMID:  24305941 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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