A 6-year audit of public-sector MR utilisation in the Western Cape province of South Africa.

Pub Date : 2022-07-22 eCollection Date: 2022-01-01 DOI:10.4102/sajr.v26i1.2464
Yusuf Parak, Razaan Davis, Michelle Barnard, Amanda Fernandez, Keith Cloete, Matodzi Mukosi, Richard D Pitcher
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Abstract

Background: Disparities in MR access between different countries and healthcare systems are well documented. Determinants of unequal access within the same healthcare system and geographical region are poorly understood.

Objective: An analysis of public sector MR utilisation in South Africa's Western Cape province (WCP).

Methods: A retrospective study of WCP MR and population data for 2013 and 2018. MR units/106 people, studies, and studies/103 people were calculated for each year, for the whole province and the 'western' and 'eastern' referral pathways, stratified by age (0-14 years, > 14 years).

Results: Between 2013 and 2018, the WCP population increased 8% (4.63 vs 5.08 × 106 people) while MR resources were unchanged ('western' = 2 units; 'eastern' = 1), equating to decreasing access (units/106 people) for the province (0.65 vs 0.59; -9.2%), the 'western' (0.97 vs 0.9; -7.2%) and 'eastern' (0.39 vs 0.35; -10.3%) pathways. In 2013, 40% (4005/10 090) of studies were in the 'eastern' pathway serving 55% (2 066 079/4 629 051) of the population. Between 2013 and 2018 'eastern' population growth (n = 286 781) exceeded 'western' (n = 168 469) by 70% (n = 118 312). By 2018, 38% (7939/12 848) of studies were performed in the 'eastern' pathway, then serving 56% (2 849 753/5 084 301) of the population. Among 0-14-year-olds, 'western' utilisation (studies/103 people) exceeded 'eastern' by a factor of approximately 2.4 throughout. In patients > 14 years, the utilisation differential increased from 1.78 to 1.98 in the review period.

Conclusion: Ensuring equitable services on the same healthcare platform requires ongoing surveillance of resource and population distribution. MR access can serve as a proxy for equity in highly specialised services.

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对南非西开普省公共部门MR利用情况的6年审计。
背景:不同国家和卫生保健系统在磁共振可及性方面的差异已有充分记录。在同一医疗保健系统和地理区域内不平等获取的决定因素了解甚少。目的:分析南非西开普省(WCP)公共部门MR的使用情况。方法:对2013年和2018年WCP MR和人群数据进行回顾性研究。每年计算全省以及“西部”和“东部”转诊途径的MR单位/106人,研究和研究/103人,按年龄(0-14岁,> 14岁)分层。结果:2013 - 2018年间,WCP人群增加了8% (4.63 vs 5.08 × 106人),而MR资源不变(“西部”= 2单位;“东部”= 1),相当于该省的访问减少(单位/106人)(0.65 vs 0.59;-9.2%),“西方”(0.97 vs 0.9;-7.2%)和“东方”(0.39 vs 0.35;-10.3%)通路。2013年,40%(4005/10 090)的研究在“东部”途径,服务于55%(2 066 079/4 629 051)的人口。2013年至2018年间,东部地区的人口增长(n = 286 781)超过西部地区(n = 168 469) 70% (n = 118 312)。到2018年,38%(7939/12 848)的研究在“东部”途径进行,然后为56%(2 849 753/5 084 301)的人口提供服务。在0-14岁的儿童中,“西方”的使用率(研究/103人)比“东方”的使用率高出约2.4倍。在> 14岁的患者中,在回顾期间,利用差异从1.78增加到1.98。结论:确保在同一医疗保健平台上提供公平的服务需要持续监测资源和人口分布。MR接入可以作为高度专业化服务公平性的代表。
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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