The impact of variation in access to care on the management of Hirschsprung disease

Al‐Jazaeri, Ayman; Al-Shanafey, Saud; Zamakhshary, Mohammed; Al-Jarbou, Wafa; Hajr, Eman; Breakeit, Mohammed; Qutob, Safi

doi:10.1016/j.jpedsurg.2012.01.052

Cited by 4 publications

(2 citation statements)

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“…Access to care is a major element of healthcare quality and is often described as the ability to obtain the optimum process and structure of care delivered by different providers [7][8][9]. We and other groups have demonstrated that the variability in access to surgical care plays a major role in determining its outcomes [10][11][12]. In order to quantify the impact of privatization on access to surgical care in the Saudi healthcare system, we compared two models of coexisting public provider (PB) and private provider (PV) in Riyadh that serve the same catchment population.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Healthcare Privatization on Access to Surgical Care: Cholecystectomy as a Model

et al. 2016

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Section: Introductionmentioning

confidence: 99%

The Impact of Healthcare Privatization on Access to Surgical Care: Cholecystectomy as a Model

et al. 2016

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“…Prompt and proper management necessitates adequate access to care which is considered a major measure of healthcare quality in general. 14 , 15 Our group and others have demonstrated that variation in a child’s access to pediatric surgical care can significantly influence both the processes and outcomes in managing various surgical conditions including Hirschsprung disease, 16 gastroschisis, 17 appendicitis 18 and hernias. 19 …”

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confidence: 99%

Variation in access to pediatric surgical care among coexisting public and private providers: inguinal hernia as a model

Al‐Jazaeri

Alshwairikh

Aljebreen

et al. 2017

Annals of Saudi Medicine

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BACKGROUNDFaced with growing healthcare demand, the Saudi government is increasingly relying on privatization as a tool to improve patient access to care. Variation in children’s access to surgical care between public (PB) and private providers (PV) has not been previously analyzed.OBJECTIVESTo compare access to pediatric surgical services between two coexisting PB and PV.DESIGNRetrospective comparative study.SETTINGSA major teaching hospital and the largest PV group in Saudi Arabia.PATIENTS AND METHODSThe outcomes for children who underwent inguinal herniotomy (IH) between May 2010 and December 2014 at both providers were with IH serving as the model. Data collected included patient demographics, insurance coverage, referral pattern and access parameters including time-to-surgery (TTS), surgery wait time (SWT) and duration of symptoms (DOS).MAIN OUTCOME MEASURE(S)TTS, SWT and DOS.RESULTSOf 574 IH cases, 56 cases of in-hospital referrals were excluded leaving 290 PB and 228 PV cases. PV patients were younger (12.0 vs 16.4 months, P=.043) and more likely to be male (81.6% vs 72.8%, P=.019), expatriates (18% vs 3.4%, P<.001) and insured (47.4% vs 0%, P<.001). The emergency department was more frequently the source for PB referrals (35.2% vs 12.7%, P<.001) while most PV patients were self-referred (72.8% vs 16.7%, P<.001). Access parameters were remarkably better at PV: TTS (21 vs 66 days, P<.001), SWT (4 vs 31 days, P<.001) and DOS (33 vs 114 days, P<.001).CONCLUSIONWhen coexisting, PV offers significantly better access to pediatric surgical services compared to PB. Diverting public funds to expand children’s access to PV can be a valid choice to improve access to care in case when outcomes with the two providers are similar.LIMITATIONSAlthough it is the first and largest comparison in the pediatric population, the sample may not represent the whole population since it is confined to a single selected surgical condition.

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Relationships Between Hospital and Surgeon Operative Volumes and Surgical Outcomes in Hirschsprung's Disease

Apfeld

Wood

Halleran

et al. 2021

Journal of Surgical Research

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The impact of variation in access to care on the management of Hirschsprung disease

Cited by 4 publications

References 27 publications

The Impact of Healthcare Privatization on Access to Surgical Care: Cholecystectomy as a Model

The Impact of Healthcare Privatization on Access to Surgical Care: Cholecystectomy as a Model

Variation in access to pediatric surgical care among coexisting public and private providers: inguinal hernia as a model

Relationships Between Hospital and Surgeon Operative Volumes and Surgical Outcomes in Hirschsprung's Disease

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