Decentralising paediatric hearing services through district healthcare screening in Western Cape province, South Africa.
Audiology
/ methods
Audiometry
/ methods
Child, Preschool
Delivery of Health Care
/ methods
Female
Health Services Accessibility
/ statistics & numerical data
Hearing
Hearing Disorders
/ diagnosis
Hearing Loss
/ diagnosis
Hearing Tests
/ methods
Humans
Male
Mass Screening
/ organization & administration
Otoacoustic Emissions, Spontaneous
Pediatrics
South Africa
/ epidemiology
childhood hearing loss
decentralisation
hearing healthcare
low- and middle-income countries
otoacoustic emissions
Journal
African journal of primary health care & family medicine
ISSN: 2071-2936
Titre abrégé: Afr J Prim Health Care Fam Med
Pays: South Africa
ID NLM: 101520860
Informations de publication
Date de publication:
29 06 2021
29 06 2021
Historique:
received:
12
01
2021
accepted:
25
04
2021
revised:
20
04
2021
entrez:
2
7
2021
pubmed:
3
7
2021
medline:
8
7
2021
Statut:
epublish
Résumé
Childhood hearing loss is a global epidemic most prevalent in low- and middle-income countries where hearing healthcare services are often inaccessible. Referrals for primary care services to central hospitals add to growing lists and delays the time-sensitive treatment of childhood hearing loss. To compare a centralised tertiary model of hearing healthcare with a decentralised model through district hearing screening for children in the Western Cape province, South Africa. A central paediatric tertiary hospital in Cape Town and a district hospital in the South Peninsula region. A pragmatic quasi-experimental study design was used with a 7-month control period at a tertiary hospital (June 2019 to December 2019). Decentralising was measured by attendance rates, travelling distance, number of referrals to the tertiary hospital and hearing outcomes. There were 315 children in the tertiary group and 158 in the district group. Data were collected from patient records and an electronic database at the tertiary hospital. Attendance rate at the district hospital was significantly higher (p 0.001). Travel distance to the district hospital was significantly shorter (p 0.001). Number of referrals to the tertiary hospital decreased significantly during the intervention period (p 0.001). Most children in both the tertiary and district groups (78.7% and 80.4%, respectively) passed initial hearing screening bilaterally. Hearing screening should be conducted at the appropriate level of care to increase access, reduce patient travelling distances and associated costs and reduce the burden on tertiary-level hospitals.
Sections du résumé
BACKGROUND
Childhood hearing loss is a global epidemic most prevalent in low- and middle-income countries where hearing healthcare services are often inaccessible. Referrals for primary care services to central hospitals add to growing lists and delays the time-sensitive treatment of childhood hearing loss.
AIM
To compare a centralised tertiary model of hearing healthcare with a decentralised model through district hearing screening for children in the Western Cape province, South Africa.
SETTING
A central paediatric tertiary hospital in Cape Town and a district hospital in the South Peninsula region.
METHODS
A pragmatic quasi-experimental study design was used with a 7-month control period at a tertiary hospital (June 2019 to December 2019). Decentralising was measured by attendance rates, travelling distance, number of referrals to the tertiary hospital and hearing outcomes. There were 315 children in the tertiary group and 158 in the district group. Data were collected from patient records and an electronic database at the tertiary hospital.
RESULTS
Attendance rate at the district hospital was significantly higher (p 0.001). Travel distance to the district hospital was significantly shorter (p 0.001). Number of referrals to the tertiary hospital decreased significantly during the intervention period (p 0.001). Most children in both the tertiary and district groups (78.7% and 80.4%, respectively) passed initial hearing screening bilaterally.
CONCLUSION
Hearing screening should be conducted at the appropriate level of care to increase access, reduce patient travelling distances and associated costs and reduce the burden on tertiary-level hospitals.
Identifiants
pubmed: 34212742
doi: 10.4102/phcfm.v13i1.2903
pmc: PMC8252164
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1-e7Commentaires et corrections
Type : ErratumIn
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