title: The consequence of delayed neurosurgical care at Tikur Anbessa Hospital, Addis Ababa, Ethiopia.
abstract: Tikur Anbessa Hospital (TAH) is the major teaching hospital for Addis Ababa University and the only tertiary referral hospital for neurosurgery in Ethiopia. We explore the consequence of delayed treatment by examining the current system in place for treating patients and the wait times experienced by patients. A retrospective chart review was carried out on patients who received a neurosurgical operation at TAH between January 1 and June 30, 2007. We divided patients into those requiring an elective procedure and those requiring emergency surgical care. Based on data entered in the chart, we determined the length of time from symptom onset to neurosurgical consultation and the time from consultation to receiving an operation. Selective cases were chosen to illustrate the effects of delayed care. A total of 172 neurosurgical operations were performed between January 1 and June 30, 2007, at TAH. Of these, 107 (62.2%) charts were available for retrospective review. Fifty-six elective cases were reviewed. The median time from symptom onset to neurosurgical consultation was 185 days. The median time from neurosurgical consultation to operation was 44 days. Fifty-one trauma/emergency surgical cases were reviewed. The median time from symptom onset or traumatic event to neurosurgical consultation was 3 days. The median time from neurosurgical consultation to operation was 1 day. Delayed neurosurgical care comes with a high personal and social cost. By measuring the time from diagnosis to treatment and taking note of institutional practices, changes can be initiated to improve patient waiting times.
authors.affiliation: Division of Neurosurgery, University of Toronto.
authors.forename: David W
authors.initials: DW
authors.lastname: Cadotte
authors.forename: Ashwin
authors.initials: A
authors.lastname: Viswanathan
authors.forename: Adam
authors.initials: A
authors.lastname: Cadotte
authors.forename: Mark
authors.initials: M
authors.lastname: Bernstein
authors.forename: Tadios
authors.initials: T
authors.lastname: Munie
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Freidberg
mesh_terms: D000328:Adult; D017281:Cost of Illness; D057210:Delayed Diagnosis / Q000191:economics / Q000639:trends*; D003906:Developing Countries / Q000191:economics; D005002:Ethiopia; D005260:Female; D017048:Health Care Costs / Q000639:trends; D006297:Health Services Accessibility / Q000191:economics / Q000639:trends*; D006801:Humans; D007223:Infant; D008297:Male; D008507:Medically Underserved Area; D009422:Nervous System Diseases / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D009493:Neurosurgery / Q000639:trends*; D019635:Neurosurgical Procedures / Q000401:mortality / Q000639:trends*; D012017:Referral and Consultation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014850:Waiting Lists; D000078329:Workforce