Delays in Laparatomy for Acute Abdomen: An Observational Study of Pre Hospital Factors, Conducted in two Hospitals (ZMH, MIIH) from January to June2020GC Addis Ababa, Ethiopia
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Date
2021
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Addis Abeba University
Abstract
Surgical Acute Abdomen is an emergency that requires prompt surgical intervention.
Multiple studies have established a direct link between delays in presentation and surgical outcome in
terms of morbidity and mortality. There are 4 layers/levels within the healthcare system: the
Environment, the Organization, the Health Care Team and the Patient. When analyzing delays it is
prudent to identify deficiencies at all 4 levels of the healthcare model interventions to correct or
mitigate deficiencies will be different at each. Even though reasons for delay are multi factorial, it is
prudent to identify deficiencies at all 4 levels of the healthcare model. This study mainly focuses on the
influences of patient and primary health care factors for surgical delay in pre hospital time. We tried to
see why patients delay in seeking help, and some factors after reaching healthcare system. Studies that
have attempted to describe factors that significantly affect Health Seeking Behaviour(HSB) during illness
episodes can be broadly classified into two. Studies which emphasize the utilization of formal health
system, or health care seeking behavior of people. These involve creating models that describe series of
steps people take towards health care model such as The Anderson, pathway models .The Andersen
healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the
use of health services. According to the model, usage of health services is determined by three
dynamics: Predisposing, Enabling factors and Need. Our study is under the second group. The Second
group of studies demonstrate that decision to engage with particular channel is influenced by variety of
factors such as socioeconomic status, age ,sex ,social status, type of illness access to service and
perceived quality of service. The second group comprises those studies which emphasize the process of
illness or HSB. Focus on specific genres of determinants which lie between patients and services such as
geographical social economic cultural and organizational factors.
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Keywords
Laparatomy ,acute abdomen