In the 1980s a local Ethiopian hospital served more locals than people transferred from distant communities
In 1985, patients admitted to a hospital in Ethiopia were mostly from the local community, even though the hospital was meant to serve even those from distant communities. This is according to researchers who reviewed hospital admissions from this period.
Researchers review how hospitals are used or how they receive new patients (their referral patterns) so that they can advise authorities on how to improve hospital performance and service to patients. In Ethiopia however, few hospital reviews exist.
In this study, the researchers wanted to evaluate how a referral hospital in southern Sidama province in Sidamo district, Ethiopia, was used by surrounding patients. They used available data from the mid 1980s.
The area that a hospital serves is known as its catchment area - in this case, the Sidamo district. A referral hospital often offers more services than other facilities in its catchment area, and thus gets patients referred to it for such services.
Here, the researchers reviewed the hospital’s admission records for the years 1985 and 1986. For each patient, they recorded age, sex, where they lived, where they were referred from, which ward they were admitted to, their diagnosis and whether or not they died during their hospital stay.
The researchers observed that 85% of admitted patients were from the Sidamo district, and only 15% from other districts. Of all those from Sidamo district, 67% lived in the local Sidama Province.
The researchers said most referrals from outside the province were men whereas the local Sidama Province admitted more women than other provinces. The surgical ward had more referrals than other wards and the children’s ward had the least referrals. The referred patients were mostly those with injuries.
The researchers also said 38.3% of the referrals were from small health posts 27.2% were from clinics and 34.2% from other hospitals. Their results also showed that referred patients stayed longer in the hospital and were more likely to die than other patients.
The researchers concluded that usage of any particular hospital depended on how accessible it was or how many patients got referred to it. They also said the results may be of interest to those who want to know what happened in the olden days.
The researchers recommended more community studies to understand exactly why people choose particular hospitals, especially when the hospital is far away.
Hospitals can serve as important complement to Primary Health Care. Periodic reviews of hospital functions are therefore needed. We have reviewed hospital use and referral pattern at a regional hospital in southern Ethiopia. 85 % of admitted patients were from the region, and 2/3 from the local province. The effect of proximity on hospital use is shown but varied for the different patient groups. Patients from the local province were less often referred than patients from the remote provinces. The hospital functions mainly as a local hospital for the Sidamo Province and less as a referral hospital for the other parts of the region. The very large functional catchment area may worsen the local population's access to the hospital.
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