Comprehensive can be effective: the influence of coverage with a health centre network on the hospitalisation patterns in the rural area of Kasongo, Zaire.
This study analyses routine data from Kasongo, Zaire in order to assess the influence of coverage with a network of health centres delivering primary care on hospitalisation patterns. Admission rates are 2.1 times higher for non-covered than for covered areas. For non-justified hospitalisations (false positives) distance decay is marked both in covered and non-covered areas, but at consistently lower levels in covered areas. For justified hospitalisations (true positives), hospitalisation rates are markedly lower in covered than in non-covered areas if one considers areas with reasonable (less than 40-50 km) access to the hospital. In more remote areas the relationship is inversed, and populations from non-covered areas do not use the hospital at all, whilst some people from covered areas do reach the hospital. Reduction of hospitalisation rates is for diseases for which standardised technical solutions of known efficacy are available at the health centres. Hospitalisation rates for the diseases usually targetted by selective PHC programmes are reduced by 86% in the covered areas as compared to the non-covered areas. Reduction in hospitalisation rates for those diseases accounts for 29% of the total coverage-related reduction.
Van Lerberghe
W
W
Kasongo Project Team, Institute for Tropical Medicine, Antwerp, Belgium.
Pangu
K
K
D003151:Community Health Centers; D015023:Democratic Republic of the Congo; D003906:Developing Countries; D006760:Hospitalization; D006780:Hospitals, Rural / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000458:organization & administration*; D012041:Regional Medical Programs; D012423:Rural Health