Exploratory analysis into reasonable timeframes for the provision of neurosurgical care in low- and middle-income countries.
Journal – World neurosurgery
Publication date – Jun – 2018
Authors – Mansouri, A; Ku, JC; Khu, KJ; Mahmud, MR; Sedney, C; Ammar, A; Godoy, BL; Abbasian, A; Bernstein, M
Keywords – consensus, resource allocation
Open access – No
Speciality – Neurosurgery
World region Global
Language – English
Submitted to the One Surgery Index on July 21, 2018 at 12:00 am
In low- and middle-income countries (LMICs), 11.8% of the need for neurosurgical care is met. Delays in seeking and receiving care may further exacerbate this. Objective analysis of delay and its consequences is contingent on reference to established resource-appropriate acceptable timeframes. This study sought to 1) establish an estimate of the landscape of care provided in LMICs and 2) explore reasonable timeframes for various stages of patient-healthcare interaction.Consensus input from neurosurgeons in select LMICs was collected; one high-income country (HIC) was included for comparison. In phase 1, participants were asked to select neurosurgical procedures performed at their centers. In phase 2, based on procedures shared among all LMICs, representative case scenarios were generated and participants provided input on acceptable timeframes for each stage of patient-healthcare interaction: 1) presentation to health services, 2) diagnosis by primary care physician, 3) referral to neurosurgical specialist care, and 4) definitive neurosurgical management.Twenty neurosurgeons across 18 centers were identified; twelve participated in phase 1 and 7 in phase 2. The range of procedures offered was broad, similar in scope to HICs, and included pediatric and adult neurosurgery, trauma, degenerative spine, and hemorrhagic stroke. Acceptable timeframes had wide ranges in certain cases; however, the overall trend demonstrated agreement between the participants.This exploratory analysis identified reasonable timeframes for the provision of neurosurgical care in LMICs. If validated, this data can be used to more objectively assess the prevalence of delay in neurosurgical care in individual LMICs, along with its consequences.
OSI Number – 10156
PMID – 29959079