Assessment of diagnostics capacity in hospitals providing surgical care in two Latin American states

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Assessment of diagnostics capacity in hospitals providing surgical care in two Latin American states


JournalEClinical Medicine
Article typeJournal research article – Clinical research
Publication date – Nov – 2020
Authors – Lina Roa, Ellie Moeller, Zachary Fowler, Rodrigo Vaz Ferreira, Sebastian Mohar, Tarsicio Uribe-Leitz, Aline Gil Alves Guilloux, Alejandro Mohar, Robert Riviello, John G Meara, Jose Emerson dos Santos Souza,Valeria Macias
KeywordsDiagnostics, global surgery, health systems, Laboratory medicine, Pathology, Radiology
Open access – Yes
SpecialityAnaesthesia, General surgery, Obstetrics and Gynaecology
World region South America
Country: Brazil, Mexico
Language – English
Submitted to the One Surgery Index on November 26, 2020 at 8:15 pm
Abstract:

Background
Diagnostic services are an essential component of high-quality surgical, anesthesia and obstetric (SAO) care. Efforts to scale up SAO care in Latin America have often overlooked diagnostics capacity. This study aims to analyze the capacity of diagnostic services, including radiology, pathology, and laboratory medicine, in hospitals providing SAO care in the states of Chiapas, Mexico and Amazonas, Brazil.

Methods
A stratified cross-sectional evaluation of diagnostic capacity in hospitals performing surgery in Chiapas and Amazonas was performed using the Surgical Assessment Tool (SAT). National data sources were queried for indicators of diagnostics capacity in terms of workforce, infrastructure and diagnosis utilization. Fisher’s exact tests and chi-square tests were used to compare categorical variables between the private and public sector in Chiapas while descriptive statistics are used to compare Amazonas and Chiapas.

Findings
In Chiapas, 53% (n = 17) of public and 34% (n = 20) of private hospitals providing SAO care were assessed. More private hospitals than public hospitals could always provide x-rays (35% vs 23.5%) and ultrasound (85% vs 47.1%). However neither sector could consistently perform basic laboratory testing such as complete blood counts (70.6% public, 65% private). In Amazonas, 30% (n = 18) of rural hospitals were surveyed. Most had functioning x-ray machine (77.8%) and ultrasound (55.6%). The majority of hospitals could provide complete blood count (66.7%) but only one hospital (5.6%) could always perform an infectious panel. Both Chiapas and Amazonas had dramatically fewer diagnostic practitioners per capita in each state compared to the national average capacity.

Interpretation
Facilities providing SAO care in low-resource states in Mexico and Brazil often lack functioning diagnostics services and workforce. Scale-up of diagnostic services is essential to improve SAO care and should occur with emphasis on equitable and adequate resource allocation.

OSI Number – 20778

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