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Waiting Too Long: The Contribution of Delayed Surgical Access to Pediatric Disease Burden in Somaliland.

Publication ,  Journal Article
Smith, ER; Concepcion, TL; Shrime, M; Niemeier, K; Mohamed, M; Dahir, S; Ismail, EA; Poenaru, D; Rice, HE; Global Initiative for Children’s Surgery,
Published in: World J Surg
March 2020

BACKGROUND: Delayed access to surgical care for congenital conditions in low- and middle-income countries is associated with increased risk of death and life-long disabilities, although the actual burden of delayed access to care is unknown. Our goal was to quantify the burden of disease related to delays to surgical care for children with congenital surgical conditions in Somaliland. METHODS: We collected data from medical records on all children (n = 280) receiving surgery for a proxy set of congenital conditions over a 12-month time period across all 15 surgically equipped hospitals in Somaliland. We defined delay to surgical care for each condition as the difference between the ideal and the actual ages at the time of surgery. Disability-adjusted life years (DALYs) attributable to these delays were calculated and compared by the type of condition, travel distance to care, and demographic characteristics. RESULTS: We found long delays in surgical care for these 280 children with congenital conditions, translating to a total of 2970 attributable delayed DALYs, or 8.4 avertable delayed DALYs per child, with the greatest burden among children with neurosurgical and anorectal conditions. Over half of the families seeking surgical care had to travel over 2 h to a surgically equipped hospital in the capital city of Hargeisa. CONCLUSIONS: Children with congenital conditions in Somaliland experience substantial delays to surgical care and travel long distances to obtain care. Estimating the burden of delayed surgical care with avertable delayed DALYs offers a powerful tool for estimating the costs and benefits of interventions to improve the quality of surgical care.

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Published In

World J Surg

DOI

EISSN

1432-2323

Publication Date

March 2020

Volume

44

Issue

3

Start / End Page

656 / 664

Location

United States

Related Subject Headings

  • Time-to-Treatment
  • Time Factors
  • Surgical Procedures, Operative
  • Surgery
  • Quality-Adjusted Life Years
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Health Services Accessibility
 

Citation

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Smith, E. R., Concepcion, T. L., Shrime, M., Niemeier, K., Mohamed, M., Dahir, S., … Global Initiative for Children’s Surgery, . (2020). Waiting Too Long: The Contribution of Delayed Surgical Access to Pediatric Disease Burden in Somaliland. World J Surg, 44(3), 656–664. https://doi.org/10.1007/s00268-019-05239-w
Smith, Emily R., Tessa L. Concepcion, Mark Shrime, Kelli Niemeier, Mubarak Mohamed, Shugri Dahir, Edna Adan Ismail, Dan Poenaru, Henry E. Rice, and Henry E. Global Initiative for Children’s Surgery. “Waiting Too Long: The Contribution of Delayed Surgical Access to Pediatric Disease Burden in Somaliland.World J Surg 44, no. 3 (March 2020): 656–64. https://doi.org/10.1007/s00268-019-05239-w.
Smith ER, Concepcion TL, Shrime M, Niemeier K, Mohamed M, Dahir S, et al. Waiting Too Long: The Contribution of Delayed Surgical Access to Pediatric Disease Burden in Somaliland. World J Surg. 2020 Mar;44(3):656–64.
Smith, Emily R., et al. “Waiting Too Long: The Contribution of Delayed Surgical Access to Pediatric Disease Burden in Somaliland.World J Surg, vol. 44, no. 3, Mar. 2020, pp. 656–64. Pubmed, doi:10.1007/s00268-019-05239-w.
Smith ER, Concepcion TL, Shrime M, Niemeier K, Mohamed M, Dahir S, Ismail EA, Poenaru D, Rice HE, Global Initiative for Children’s Surgery. Waiting Too Long: The Contribution of Delayed Surgical Access to Pediatric Disease Burden in Somaliland. World J Surg. 2020 Mar;44(3):656–664.
Journal cover image

Published In

World J Surg

DOI

EISSN

1432-2323

Publication Date

March 2020

Volume

44

Issue

3

Start / End Page

656 / 664

Location

United States

Related Subject Headings

  • Time-to-Treatment
  • Time Factors
  • Surgical Procedures, Operative
  • Surgery
  • Quality-Adjusted Life Years
  • Male
  • Infant, Newborn
  • Infant
  • Humans
  • Health Services Accessibility