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Sökning: WFRF:(Leather A. J.M.) > Travel time and per...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004880naa a2200469 4500
001oai:lup.lub.lu.se:091cdbe8-ab31-4dfa-82d4-71d2588e0f38
003SwePub
008210105s2020 | |||||||||||000 ||eng|
009oai:prod.swepub.kib.ki.se:145471150
024a https://lup.lub.lu.se/record/091cdbe8-ab31-4dfa-82d4-71d2588e0f382 URI
024a https://doi.org/10.1136/bmjgh-2020-0039432 DOI
024a http://kipublications.ki.se/Default.aspx?queryparsed=id:1454711502 URI
040 a (SwePub)lud (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a art2 swepub-publicationtype
072 7a ref2 swepub-contenttype
100a Van Duinen, Alex J.u St. Olav’s University Hospital,Norwegian University of Science and Technology4 aut0 (Swepub:lu)aa1754va
2451 0a Travel time and perinatal mortality after emergency caesarean sections : An evaluation of the 2-hour proximity indicator in Sierra Leone
264 c 2020-12-21
264 1b BMJ,c 2020
520 a Introduction Longer travel times are associated with increased adverse maternal and perinatal outcomes. Geospatial modelling has been increasingly used to estimate geographic proximity in emergency obstetric care. In this study, we aimed to assess the correlation between modelled and patient-reported travel times and to evaluate its clinical relevance. Methods Women who delivered by caesarean section in nine hospitals were followed up with home visits at 1 month and 1 year. Travel times between the location before the delivery and the facility where caesarean section was performed were estimated, based on two models (model I Ouma et al; model II Munoz et al). Patient-reported and modelled travel times were compared applying a univariable linear regression analysis, and the relation between travel time and perinatal mortality was assessed. Results The median reported travel time was 60 min, compared with 13 and 34 min estimated by the two models, respectively. The 2-hour access threshold correlated with a patient-reported travel time of 5.7 hours for model I and 1.8 hours for model II. Longer travel times were associated with transport by boat and ambulance, visiting one or two facilities before reaching the final facility, lower education and poverty. Lower perinatal mortality was found both in the group with a reported travel time of 2 hours or less (193 vs 308 per 1000 births, p<0.001) and a modelled travel time of 2 hours or less (model I: 209 vs 344 per 1000 births, p=0.003; model II: 181 vs 319 per 1000 births, p<0.001). Conclusion The standard model, used to estimate geographical proximity, consistently underestimated the travel time. However, the conservative travel time model corresponded better to patient-reported travel times. The 2-hour threshold as determined by the Lancet Commission on Global Surgery, is clinically relevant with respect to reducing perinatal death, not a clear cut-off.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Hälsovetenskapx Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi0 (SwePub)303022 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Health Sciencesx Public Health, Global Health, Social Medicine and Epidemiology0 (SwePub)303022 hsv//eng
653 a geographic information systems
653 a maternal health
700a Adde, Håvard A.u Norwegian University of Science and Technology4 aut
700a Fredin, Olau Norwegian University of Science and Technology,Geological Survey of Norway4 aut
700a Holmer, Hampusu Karolinska Institutet,Karolinska Institute4 aut0 (Swepub:lu)med-hsh
700a Hagander, Larsu Lund University,Lunds universitet,Barnkirurgi,Forskargrupper vid Lunds universitet,Pediatric surgery,Lund University Research Groups,Skåne University Hospital4 aut0 (Swepub:lu)med-lhd
700a Koroma, Alimamy P.u University of Sierra Leone,Ministry of Health and Sanitation, Sierra Leone4 aut
700a Koroma, Michael M.u Ministry of Health and Sanitation, Sierra Leone,University of Sierra Leone4 aut
700a Leather, Andrew J.M.u King's College London4 aut
700a Wibe, Arneu Norwegian University of Science and Technology,St. Olav’s University Hospital4 aut
700a Bolkan, Håkon A.u Norwegian University of Science and Technology,St. Olav’s University Hospital4 aut
710a St. Olav’s University Hospitalb Norwegian University of Science and Technology4 org
773t BMJ Global Healthd : BMJg 5:12q 5:12x 2059-7908
856u http://dx.doi.org/10.1136/bmjgh-2020-003943x freey FULLTEXT
856u https://gh.bmj.com/content/bmjgh/5/12/e003943.full.pdf
8564 8u https://lup.lub.lu.se/record/091cdbe8-ab31-4dfa-82d4-71d2588e0f38
8564 8u https://doi.org/10.1136/bmjgh-2020-003943
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:145471150

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