Addressing Disparities in Access to Mechanical Thrombectomy in a Developing Country: Insights from a Public-Private Partnership in Colombia.

IF 1.2 4区医学 Q4 HEALTH POLICY & SERVICES

Journal of Health Care for the Poor and Underserved Pub Date : 2025-01-01 DOI:10.1353/hpu.2025.a959120

Juan Diego Martínez-Lemus, Stefania Forero-Caldas, Annelise Velasco de Azevedo-Pereira, Andrea Del Pilar González-Gamboa, Neiry María Zapa-Pérez, Hernán Bayona-Ortiz, Claudio Alejandro Jiménez-Monsalve

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引用次数: 0

Abstract

Introduction: Access to mechanical thrombectomy (MT) for ischemic stroke with large vessel occlusion is limited in upper middle-income countries.

Objective: To describe the experience of a public-private partnership (PPP) aimed at enhancing MT access in Bogotá, Colombia's public health care network.

Methods: Cross-sectional study describes access to MT under two drip-and-ship referral models (model A and B). Bivariate analysis was conducted using SPSS V25.

Results: Between 2021 and 2023, there were 116 MT code activations. Over sixty percent (61.6%) successfully accessed MT, while administrative barriers prevented access in the remaining cases. There was no significant difference in MT access between PPP models A (60%) and B (66.7%). Model B faced prominent administrative issues related to insurance.

Conclusions: Public-private partnerships significantly improved MT access in Bogotá, benefiting nearly two-thirds of the studied population. However, administrative challenges persist. Effective referral systems and robust national policies are crucial for further enhancing MT access.

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解决发展中国家在机械取栓方面的差距：来自哥伦比亚公私合作伙伴关系的见解。

导读：在中高收入国家，机械取栓术（MT）治疗缺血性卒中大血管闭塞是有限的。目的：描述旨在提高MT在波哥大的经验，哥伦比亚的公共卫生保健网络公私伙伴关系（PPP）。方法：横断面研究描述了两种滴船转诊模型（模型A和模型B）下的MT获取情况。采用SPSS V25进行双变量分析。结果：在2021年至2023年期间，有116个MT代码激活。超过60%（61.6%）的人成功访问了MT，而其余病例的管理障碍阻碍了访问。PPP模式A（60%）和B（66.7%）在MT接入方面无显著差异。模式B面临着与保险相关的突出行政问题。结论：公私伙伴关系显著改善了波哥大的MT获取，使近三分之二的研究人口受益。然而，管理方面的挑战依然存在。有效的转诊制度和强有力的国家政策对于进一步提高MT的可及性至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Health Care for the Poor and Underserved Multiple-

CiteScore

2.00

自引率

7.10%

发文量

154

期刊介绍： The journal has as its goal the dissemination of information on the health of, and health care for, low income and other medically underserved communities to health care practitioners, policy makers, and community leaders who are in a position to effect meaningful change. Issues dealt with include access to, quality of, and cost of health care.