Open AccessThe Third Delay in General Surgical Care in a Regional Referral Hospital in Soroti, Uganda
Author(s) -
Starr Savannah,
Kim Woon Cho,
Oke Rasheedat,
Carvalho Melissa,
Ledesma Yera,
Okullu Silas,
Ariokot Mary Goretty,
Wange Andrew Hyginus,
Agwang Esther,
Ekuchu Peter,
Boeck Marissa,
Juillard Catherine,
Ajiko Mary Margaret,
Dicker Rochelle A.
Publication year - 2022
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-022-06591-0
Subject(s) - medicine , referral , emergency medicine , adverse effect , abdominal surgery , health care , vascular surgery , tertiary referral hospital , economic shortage , cardiac surgery , medical emergency , general surgery , surgery , retrospective cohort study , family medicine , linguistics , philosophy , government (linguistics) , economics , economic growth
Abstract Background Building capacity for surgical care in low‐and‐middle‐income countries is essential for the improvement of global health and economic growth. This study assesses in‐hospital delays of surgical services at Soroti Regional Referral Hospital (SRRH), a tertiary healthcare facility in Soroti, Uganda. Methods A prospective general surgical database at SRRH was analyzed. Data on patient demographics, surgical characteristics, delays of care, and adverse clinical outcomes of patients seen between January 2017 and February 2020 were extracted and analyzed. Patient characteristics and surgical outcomes, for those who experienced delays in care, were compared to those who did not. Results Of the 1160 general surgery patients, 263 (22.3%) experienced at least one delay of care. Deficits in infrastructure, particularly lacking operating theater space, were the greatest contributor to delays ( n = 192, 73.0%), followed by shortage of equipment ( n = 52, 19.8%) and personnel ( n = 37, 14.1%). Male sex was associated with less delays of care (OR 0.63) while undergoing emergency surgeries (OR 1.65) and abdominal surgeries (OR 1.44) were associated with more frequent delays. Delays were associated with more adverse events (10.3% vs. 5.0%), including death (4.2% vs. 1.6%). Emergency surgery, unclean wounds, and comorbidities were independent risk factors of adverse events. Discussion Patients at SRRH face significant delays in surgical care from deficits in infrastructure and lack of capacity for emergency surgery. Delays are associated with increased mortality and other adverse events. Investing in solutions to prevent delays is essential to improving surgical care at SRRH.