Evidence map›Paper›PMID 36590374›Full record

ArticleAnnals of global health2022

Access and Financial Burden for Patients Seeking Essential Surgical Care in Pakistan.

Lubna Samad, Muhammad Nabeel Ashraf, Ammar Ali Mohammad, Irum Fatima, Zachary Fowler, Katherine Albutt, Asad Latif, John G Meara, Manon Pigeolet

Abstract read
In one paragraph

Article in Annals of global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Lubna SamadInteractive Research and Development (IRD), Karachi, Pakistan.ORCID 0000-0002-6365-8796
Muhammad Nabeel AshrafAugusta University - Medical College of Georgia, Augusta, GA, USA.ORCID 0000-0002-1564-1885
Ammar Ali MohammadInteractive Research and Development (IRD), Karachi, Pakistan.ORCID 0000-0002-5246-5104
Irum FatimaInteractive Research and Development (IRD), Karachi, Pakistan.ORCID 0000-0002-9877-5968
Zachary FowlerProgram in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-4777-413X
Katherine AlbuttDivision of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA.ORCID 0000-0003-1735-7316
Asad LatifDepartment of Anaesthesia, Aga Khan University, Karachi, Pakistan.ORCID 0000-0002-1298-1198
John G MearaProgram in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.ORCID 0000-0003-4369-3209
Manon PigeoletProgram in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.ORCID 0000-0003-0683-9520

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Pakistan is a lower middle-income country in South Asia with a population of over 220 million. With the recent development of national health programs focusing on surgical care, two areas of high priority for research and policy are access and financial risk protection related to surgery. This is the first study in Pakistan to nationally assess geographic access and expenditures for patients undergoing surgery. Methods: This is a cross-sectional study of patients undergoing laparotomy, cesarean section, and surgical management of a fracture at public tertiary care hospitals across the country. A validated financial risk protection tool was adapted for our study to collect data on the socio-economic characteristics of patients, geographic access, and out-of-pocket expenditure. Results: A total of 526 patients were surveyed at 13 public hospitals. 73.8% of patients had 2-hour access to the facility where they underwent their respective surgical procedures. A majority (53%) of patients were poor at baseline, and 79.5% and 70.3% of patients experienced catastrophic health expenditure and impoverishing health expenditure, respectively. Discussion: A substantial number of patients face long travel times to access essential surgical care and face a high percentage of impoverishing health expenditure and catastrophic health expenditure during this process. This study provides valuable baseline data to health policymakers for reform efforts that are underway. Conclusions: Strengthening surgical infrastructure and services in the existing network of public sector first-level facilities has the potential to dramatically improve emergency and essential surgical care across the country.

Indexed as

Cesarean SectionFinancial StressCross-Sectional StudiesFemaleHealth ExpendituresHumansPakistanPregnancyglobal healthGlobal Surgeryhealth financing

Identifiers

PMID36590374
PMCPMC9784127

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.